13 hours ago
RE: Discussion – Week 7
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NURS 6052: Essentials of Evidence-Based Practice
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Knight, F., Ridge, D., McShane, R., Ryan, S., & Griffith, L. (2017). Care, control, and the electroconvulsive therapy ritual: Making sense of polarized patient narratives. Qualitative Health Research,27(11), 1675-1685. doi:10.1177/1049732317701403
I selected a qualitative study conducted by Knight, Ridge, McShane, Ryan, and Griffith (2017) which aimed to gain a better understanding about the differences regarding patients’ opinions regarding their respective experiences with electroconvulsive therapy (ECT). Quantitative research indicates the efficacy of ECT; however, both positive and negative post procedure patient reports are common. Contradictory patient evaluations need to be studied to help clinicians optimize the ECT experience which could improve compliance (Knight, Ridge, McShane, Ryan, & Griffith, 2017). Moreover, ECT is one of the few options for treatment resistant depression, however, it is often stigmatized as barbaric. Negative perceptions about ECT treatment are a primary barrier preventing patients from agreeing to the treatment.
The results of the study identified several themes consistent with participants who associated ECT as a positive experience; trust in staff, a sense of being cared for, thorough explanation of the procedure and associated risks and benefits, autonomy in making the decision to undergo ECT treatment, and good relationships with the ECT staff and psychiatrists. In contrast, participants who reported negative ECT experiences described ECT staff as cold or disconnected, reported feelings that they were misunderstood, that their concerns were dismissed, that they were not well informed of the procedure, and that they had little or no choice in agreeing to ECT treatment (Houghton et al., 2017).
Qualitative Design
Quantitative data can identify the divergence of patient onions regarding ECT exists. However, it cannot identify why these differences are occurring. Polit and Beck (2017) report that phenomenology, a construct used qualitative research, focuses on the meaning of lived experiences of humans (Polit & Beck, 2017). The researchers of this study employed narrative style interviews with patients regarding their lived experiences of ECT. The interviews were recorded and subsequently transcribed for analysis; data saturation was achieved. Participants provided oral history to tell their ECT story, in their own words, from their own perspective (Knight et al., 2017). I believe that the qualitative design was appropriate for this type of research, as the aim was to establish a phenomenological relationship.
Ethical Considerations
According to Houghton, Case, Shaw, and Murphy (2010), informed consent can be challenging when conducting qualitative research particularly because the researcher cannot always control the direction of interviews or observations (Houghton, Case, Shaw, & Murphy, 2010). The researchers in the ECT study declared that while ethical issues regarding ECT itself were outside the scope of their research. However, the study was approved by the Multicentre Research Ethics Committee. Additionally, research participants were provided comprehensive written information about the study, were allotted adequate time to review these materials, were afforded the opportunity to ask questions, and all signed written consent forms for their narrative interviews to be used in the study (Houghton et al., 2010).
Another ethical issue pertaining to qualitative research is confidentiality. Because of the intimate nature of qualitative data, participants may be vulnerable to embarrassment and risk of exposure if too much personal information is disclosed (Houghton et al., 2010) To mitigate the ethical risk regarding confidentiality, the researchers of this study were offered the choice of using pseudonyms in place of their real names. While most of the participants chose to use a pseudonym, some of the participants had already spoken publically about their ECT experience and elected to use their real name. Nonetheless, informed consent in this regard was obtained from each participant (Kight et al., 2017).
Variations in Qualitative and Quantitative Research Designs
Williamson (2009) asserts that qualitative research is descriptive and provides insight and understanding into human experiences. Qualitative researchers seek to understand how participants think and feel.
These data are not numerical; rather, they are full and rich descriptions from participants who are experiencing the phenomenon under study. The goal of qualitative research is to uncover the truths that exist and develop a complete understanding of reality and the individual’s perception of what is real. (Williamson, p. 202, 2010).
Qualitative research seeks to uncover the subjective, whereas quantitative research focuses on analyzing trends in objective data. The quality of the information obtained through the narrative interviews in the ECT study provided significant insight into the feelings and perceptions of the participants. Quantitative analysis would not have been able to obtain this type of information. The information obtained in the qualitative study regarding patients experiences regarding ECT can be used to impact evidence-based practice in a more significant and meaningful way than the quantitative data alone.
References
Houghton, C. E., Casey, D., Shaw, D., & Murphy, K. (2010). Ethical challenges in qualitative research: Examples from practice. Nurse Researcher,18(1), 15-25. doi:10.7748/nr2010.10.18.1.15.c8044
Knight, F., Ridge, D., Mcshane, R., Ryan, S., & Griffith, L. (2017). Care, control, and the electroconvulsive therapy ritual: Making sense of polarized patient narratives. Qualitative Health Research,27(11), 1675-1685. doi:10.1177/1049732317701403
Polit, D. F., & Beck, C. T. (2017). Nursing research generating and assessing evidence for nursing practice. Philadelphia: Wolters Kluwer.
Williamson, K. M. (2009). Evidence-based practice: Critical appraisal of qualitative evidence. Journal of the American Psychiatric Nurses Association,15(3), 202-207. doi:10.1177/1078390309338733
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