Critical Appraisal of Qualitative Research

Article 1: French, L., Moran, P., Wiles, N., Kessler, D. and Turner, K.M., 2019. GPs’ views and experiences of managing patients with personality disorder: a qualitative interview study. BMJ open, 9(2), p.e026616.

The Joanna Briggs Critical Analysis Tool for Qualitative Studies tool mentions to determine whether or not philosophical perspective and the research methodology are congruent (, 2020). In the study, it is seen that descriptive perspective and interview methodology has been used which are congruent to other another. This is because in interview methodology detailed feelings, expression and views of the participants are collected regarding the study topic through questionnaires which are then essential to be described in detail. It is required so that proper understanding of the thoughts and concepts of the participants are developed in creating assumptions regarding research topic to resolve the question and issues raised in the study (Rothschild et al. 2019). However, it is mentioned by Munn et al. (2019), that lack of conguregency between research philosophy and research methodlogy leads researcher unable to execute gathering of data as per mentioned phenomenon. Thus, the mentioned aspect by the tool is evident to be considered in criticiquing the article to ensure whether proper process is followed by the research to develop the study.


The congruity between research questions and research methodology is essential for addressing and resolving the raised issues in the study (, 2020). However, ability to develop congrugence leads researcher unable develop proper solution for the issues in turn hindering the study progression (Buccheri and Sharifi, 2017). Therefore, it is effective aspect to be focused in the tool. In the study, the interview approach has been undertaken to identify the view of GPs in managing people with personality disorder and determining role of IAPT in the progress which ensures congruity between the research methodology and research question. This is because through interview it allows establishment of proper interaction creating opportunity to gather detailed views and expression of the individuals regarding any raised issue in the study (Stadnick et al. 2017). However, the limitation to be faced by the interview process is that personal perspectives of the researcher may have influenced in discussing the results leading to baised conclusion. The survey research method could have been included with the interview process. This is because it do not allows results to be discussed through personal perception of the researcher avoiding biases to be formed as well as statistical data collected through survey can be compared with interview data to ensure its reliabiity (McClelland, 2016).

There is congruity between research methodology and data collection method. The telephonic interaction allows to resolve physical barriers making the participants to directly interact with the researcher ensuring rich and well-descriptive information to be collected in resolving the raised question in the study (Zhang et al. 2017). However, face-to-face interaction is more effective compared to telephonic interaction as it helps resecher to understand emotions and feelings behind the information assisting them to discuss the results with lesser biases and implementation of own perscpectives (Johnson and Lester, 2016). There is a congruity between the data analysis method and research methodology in the mentioned study (French et al. (2019). This is required to be established as it allows proper representation of the gathered data to be easily understood by the reader (, 2020). The study used thematic analysis as data analysis which is congruent with descriptive research methodology because the analysis allows the researcher to provide detailed description of databases and information of individual experiences by interpreting them in a systematic ay under potential themes (Gray and Brown, 2017).

In the study, the researcher beliefs and values which influence the research are not declared creating confusion whether they have manipulated the resulst or not. The ethical approval is gathered by the study which acts as its strength as the study ensures no violation of rules is executed. Moreover, effective relationship is present in the study between the conclusion drawn from the data collected through the interview which acts as strength for the study. This is because proper relation between the conclusion and data analysis of the study seeks to mention proper proof regarding the summarised information presented that resolves the raised questions in the study (Arbeau et al. 2017). The limitation of the study is that since all the PD diagnosis is done in secondary care thus there chances GP’s selected participants who have no formal diagnosis of PD (French et al. 2019).

Article 2: Waugh, W., Lethem, C., Sherring, S. and Henderson, C., 2017. Exploring experiences of and attitudes towards mental illness and disclosure amongst health care professionals: a qualitative study. Journal of mental health, 26(5), pp.457-463.

The study by Waugh et al. (2017) is to be critically analysed by using CASP Tool. The CASP tool for qualitative study informs that clear aim of the research is to be mentioned (, 2020). This is because clarified aim assists the researcher to properly inform the purpose of the study (Backman Lönn et al. 2019). The study has a clarified aim which explains that the purpose of the research is to determine the experiences and attitudes of the health professionals (HPs) in disclosing regarding mental illness at the workplace. The CASP tool mentions to determine whether or not the qualitative methodology is appropriate for the selected article (Lui et al. 2018). The qualitative methodology is appropriate for the study because without it the views and attitudes of the HPs regarding disclosure of mental illness at the workplace cannot be determined.

The CASP tool mentions that the research design is to be appropriate for the study. The study by McPhail (2019) that this aspect of the tool is effective approach as proper research design allows effective methods and techniques to be chosen for the proper execution of the study. The qualitative research design is found to address the aim of the study as it would help to gather thoughts and perception of the HPs regarding mental illness disclosure at the workplace which is the key purpose of the research. The CASP tool mentions proper sampling strategy to be used in the study. The convenience sampling method is used which acts as strength of the study as it allows cost-effective and less time-consuming way of recruiting samples for the study (Labrague et al. 2018). However, use of probability sampling would be better for the study as it allows random slection of participants from wider population where each has equal chances of being chosen allowing researcher to use greater sample size in executing the research (Etikan and Bala, 2017). In the study, the samples are collected from the NHS trust which offers care in a specific area regarding mental illness as well as others. This limits the study results to be generalised as collection of sample from different areas regarding menal illness would have provided greater knolwdege about wider factors which are affecting the perception regarding the illness.

The CASP tool mentions the data collection to be done in a way that it addresses the issue in the study (Adib-Hajbaghery et al. 2017). The use of interview approach as strength in the study as it allows expanded questions to be asked to the participants to gather comprehensive information (Guerrero-Castañeda et al. 2017). In the study, since the views of expressing mental illness in the workplace from the HPs is required to be gathered therefore interview approach is appropriate to be used for collecting comprehensive data in execution of the study.

There are no relationship between the researcher and participants been adequately considered in the study due to which bias or influence to be faced could not be considered. The ethical issues are considered in the study which acts as strength as it means proper rules are followed in developing the study (Pietilä et al. 2020). The thematic analysis is the data analysis approach used in the study is considerably rigorous. The rigorous data analysis acts as strength for the study as it allows proper collection of required evidence in careful manner (Javadi and Zarea, 2016). The results are mentioned clearly in the study which is evident as it mentions that the HPs fear discrimination as stigma to be potential attitudes to be faced on disclosing mental illness in the workplace. The conclusion drawn in the study is properly justified by the results as it mentions in a clarified manner.

Article 3: Dickens, G.L., Lamont, E., Mullen, J., MacArthur, N. and Stirling, F.J., 2019. Mixed‐methods evaluation of an educational intervention to change mental health nurses' attitudes to people diagnosed with borderline personality disorder. Journal of clinical nursing, 28(13-14), pp.2613-2623.

The Mixed Method Appraisal (MMA) Tool is to be used for critically appraising the article by Dickens et al. (2018). The tool mentions that a clarified research question is to be present because research questions mention what is to be explored in the study and helps to understand later the way rest of the study is to be developed to gather effective results in making an enriched study where the questions are properly resolved (, 2018). The research by Dickens et al. (2018) developed the research question to examine and explore the responses of the mental health nurses for and experiences regarding an education intervention for improving the attitudes regarding individuals who are diagnosed with borderline personality disorder (BPD). The data collected helps to address the research question which is evident as the data mentioned varied messages and perception of the nurses regarding the implementation of educational intervention for improving people with BPD.

In the study, no proper rationale explaining the reason behind the use of mixed method is provided. The reason behind the use of the specific method is to be understood so that the cause of not selected other research methods, as well as the way selected method is going to influence the researcher in collecting results, can be determined (Huber et al. 2017). The different components collected in the study are integrated for answering the research question. This is evident as overall information is collaboratively presented through common themes to develop a complete picture in resolving the raised question in the study. The MMA tool mentions that the outputs of the research are to be presented in such a way so that the qualitative and quantitative components are properly integrated into interpreting the results. The fact is supported by Husebø et al. (2018) where it is mentioned that the aspect is required because such interpretation shows the added value of executing mixed research rather than performing two separate studies. In the study, the outcomes of the research are found to be adequately interpreted by integrating the qualitative as well as qualitative components of the collected data. This is evident as results through quantitative examination revealed sustainable changes which are consisted with the gains in attitudes expected for the treatment provided along with changes in suicidal perception and attitudes of BPD patients and qualitative results informed hostility related to use of positive perception and biosocial model for the involvement of nurses in caring for the patients. The MMA Tool mentions that inconsistencies and divergencies between qualitative as well as quantitative data are to be adequately addressed. This is because it helps to inform the conflicts present between the qualitative and quantitative data collected (, 2018). In the study, no divergence between qualitative and quantitative data was faced.

Article 4: Aarons, G.A. and Sawitzky, A.C., 2006. Organizational climate partially mediates the effect of culture on work attitudes and staff turnover in mental health services. Administration and policy in mental health and mental health services research, 33(3), p.289.

In order to appraise the study by Aarons and Sawitzky (2006), the CEBMA Tool is to be used. The CEBMA tool mentions to determine whether the study has mentioned a clearly focussed issue ( 2020). This is an essential aspect to be asked as mentioned by Connelly (2016) because it would help the reader to develop an overview regarding the aspects of being explored and mentioned in the study. In the study, a clearly focussed question is asked by the researcher which is evident as it is mentioned that the study is going to evaluate full as well as the partial model effect of culture and climate on attitude at work and the subsequent effect of work attitudes on turnover of staffs. The CEBMA tool mentions to determine whether the study design used in effective for resolving the raised research question ( 2020). This is because if the study design fails to resolve raised questions then it would lead to form invalid research that would create waste of time and money (Thorne et al. 2016). The study design which is survey is appropriate for the research question as it helped to collect valuable data to develop answers for the raised issues in the study.

The CEBMA Tool mentions to determine whether the way the selection of the participants done is clearly described ( 2020). The understanding regarding the way participants are selected in the study is essential to determine whether or not the selected participants are representative of the population and the responses gathered from then can generalised (Moule et al. 2016). The study clearly mentioned the way participants are selected which is evident as the researcher informed they selected 322 participants who are participating in organisation issue study within 49 public-sector healthcare programmes (Aarons and Sawitzky, 2006). In the study, no selection bias are mentioned that are considered in selecting the participants or sample. A satisfactory response rate is achieved as all the participants who were selected for the study expressed the opinion to show full participation in the research. The CEBMA tool mentions that statistical significance in the survey is to be determined ( 2020). This is because statistical significance ensures the gathered data is going to create positive impact on determining appropriate results of the study. In the study, effective statistical significance is assessed by considering the p-value for each statistical data.

The CEBMA tool mentions that measurements or questionnaires are required to be valid and reliable for survey study ( 2020). This is because valid and reliable questionnaires help the research to gather high-quality data required to execute the study and resolve the raised issues (Vermeir et al. 2018). The CEBMA tool mentions to determine the confidence interval in the study ( 2020). In the article, no information regarding confidence intervals are mentioned. This acts as limitation of the study as confidence intervals informs the estimated range under which the real answer lies in the satistical data collected within the study (Staggs, 2019). Thus, without confidence interval calculation the variations in the data collected to be considered cannot be determined in the study. The results can be applied to any health organisation as it is gathered by analysing the attitudes and perception of healthcare staffs to work based on work culture and climate.


Reflection is important in the study as it helps to determine what has been learned and what more to be learned to develop effective strength and resolve weakness in the academic field (Reljić et al. 2019). The articles selected are critiqued by using four different critical analysis tools that are CASP tool for qualitative studies, CEBM tool for survey, Mixed Methods Appraisal Tool and Joanna Briggs Qualitative Appraisal tool. The use of each of the tools helped me to understand the various aspects to be considered within the studies for selecting and collecting potential evidence to be used in the study. Previously, I only had knowledge regarding the way to use the CASP tool. However, the execution of the critical analysis helped me to understand the way various other critical appraisals to be used in gathering value evidence in practice to be used.

The critical analysis of the four articles led me to understand that a potential article is one in which a clarified aim or the research questions or issues are clearly defined. This is because clarified aim or issues in the study helps to understand the purpose to be fulfilled in the research as well as helps the reader to determine at the initiation if the study is valid to be used as evidence in selected practice (LoBiondo-Wood and Haber, 2017). Thus, I learned that in collected evidence to execute evidence-practice the aim or research issues explored in the selected study is to be initially analysed to determine if it is potential to use in the selected field of work. The critical analysis of the articles also led me to understand that appropriateness, validity and reliability of the research methodology used in the study is to be determined while gathering evidence. This is because studies that use valid and appropriate research methodology in executing the research helps in collecting reliable data that resolve the raised issues in the study (Lima et al. 2016).

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The critical analysis helped me to learn that in survey research statistical significance and confidence intervals are to be considered so that the true validity level of the results can be determined (LoBiondo-Wood et al. 2017). This is because using low-quality data as evidence in practice leads to create error at work. The critical analysis informed me that while collected evidence biases of the data to be identified. This is because biasness informs the level or extent of deviation from the truth of the data (LoBiondo-Wood and Haber, 2017). Thus, I understood that less biased data could be used as potential evidence in practice as they have an increased extent of the truth. The critical analysis of the articles also helped me to understand that while collecting evidence extent of influence of the opinion, assumption and beliefs of the researcher are to be determined. This is because it would help me understand to what extent the data interpreted are evident to be used (LoBiondo-Wood and Haber, 2017). The critical analysis also led me to understand the questions to be raised in differentiating between weak and strong evidence so that effective evidence-based practice can be established.


Aarons, G.A. and Sawitzky, A.C., 2006. Organizational climate partially mediates the effect of culture on work attitudes and staff turnover in mental health services. Administration and policy in mental health and mental health services research, 33(3), p.289.

Adib-Hajbaghery, M., Adib, M.E. and Eshraghi Arani, N., 2017. Evaluating the quality of randomized trials published in Persian nursing journals with more than 10 years of publishing using the CASP checklist. Iran Journal of Nursing, 30(109), pp.1-9.

Arbeau, K., Theall, L., Willoughby, K., Berman, J.M. and Stewart, S.L., 2017. What Happened? Exploring the Relation between Traumatic Stress and Provisional Mental Health Diagnoses for Children and Youth. Psychology, 8(14), pp.2485-2495.

Backman Lönn, B., Olofsson, N. and Jong, M., 2019. Translation and validation of the Clinical Trial Nursing Questionnaire in Swedish—A first step to clarify the clinical research nurse role in Sweden. Journal of clinical nursing, 28(13-14), pp.2696-2705.

Buccheri, R.K. and Sharifi, C., 2017. Critical Appraisal Tools and Reporting Guidelines for Evidence‐Based Practice. Worldviews on Evidence‐Based Nursing, 14(6), pp.463-472.

Carter, E.J., Mastro, K., Vose, C., Rivera, R. and Larson, E.L., 2017. Clarifying the conundrum: evidence-based practice, quality improvement, or research?: The clinical scholarship continuum. JONA: The Journal of Nursing Administration, 47(5), pp.266-270.

Connelly, L.M., 2016. Trustworthiness in qualitative research. Medsurg Nursing, 25(6), pp.435-437.

Dickens, G.L., Lamont, E., Mullen, J., MacArthur, N. and Stirling, F.J., 2019. Mixed‐methods evaluation of an educational intervention to change mental health nurses' attitudes to people diagnosed with borderline personality disorder. Journal of clinical nursing, 28(13-14), pp.2613-2623.

Etikan, I. and Bala, K., 2017. Combination of Probability Random Sampling Method with Non Probability Random Sampling Method (Sampling Versus Sampling Methods). Biometrics & Biostatistics International Journal, 5(6).pp.90-111.

French, L., Moran, P., Wiles, N., Kessler, D. and Turner, K.M., 2019. GPs’ views and experiences of managing patients with personality disorder: a qualitative interview study. BMJ open, 9(2), p.e026616.

Gray, R. and Brown, E., 2017. What does mental health nursing contribute to improving the physical health of service users with severe mental illness? A thematic analysis. International journal of mental health nursing, 26(1), pp.32-40.

Guerrero-Castañeda, R.F., Menezes, T.M.O. and Ojeda-Vargas, M.G., 2017. Characteristics of the phenomenological interview in nursing research. Rev Gaúcha Enferm, 38(2), p.e67458.

Huber, E., Kleinknecht‐Dolf, M., Müller, M., Kugler, C. and Spirig, R., 2017. Mixed‐method research protocol: defining and operationalizing patient‐related complexity of nursing care in acute care hospitals. Journal of advanced nursing, 73(6), pp.1491-1501.

Husebø, A.M.L., Storm, M., Våga, B.B., Rosenberg, A. and Akerjordet, K., 2018. Status of knowledge on student‐learning environments in nursing homes: A mixed‐method systematic review. Journal of clinical nursing, 27(7-8), pp.e1344-e1359.

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Johnson, W.L. and Lester, J.C., 2016. Face-to-face interaction with pedagogical agents, twenty years later. International Journal of Artificial Intelligence in Education, 26(1), pp.25-36.

Labrague, L.J., Hammad, K., Gloe, D.S., McEnroe‐Petitte, D.M., Fronda, D.C., Obeidat, A.A., Leocadio, M.C., Cayaban, A.R. and Mirafuentes, E.C., 2018. Disaster preparedness among nurses: a systematic review of literature. International nursing review, 65(1), pp.41-53.

Lima, J.V.F., Guedes, M.V.C., Silva, L.D.F.D., Freitas, M.C.D. and Fialho, A.V.D.M., 2016. Usefulness of the comfort theory in the clinical nursing care of new mothers: critical analysis. Revista gaucha de enfermagem, 37(4).pp.23-56.

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Stadnick, N., Chlebowski, C., Baker-Ericzén, M., Dyson, M., Garland, A. and Brookman-Frazee, L., 2017. Psychiatric comorbidity in autism spectrum disorder: Correspondence between mental health clinician report and structured parent interview. Autism, 21(7), pp.841-851.

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Waugh, W., Lethem, C., Sherring, S. and Henderson, C., 2017. Exploring experiences of and attitudes towards mental illness and disclosure amongst health care professionals: a qualitative study. Journal of mental health, 26(5), pp.457-463.

Zhang, X., Kuchinke, L., Woud, M.L., Velten, J. and Margraf, J., 2017. Survey method matters: Online/offline questionnaires and face-to-face or telephone interviews differ. Computers in Human Behavior, 71, pp.172-180.

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