PATIENT EXPERIENCE OF CENTRALIZED ACUTE STROKE CARE PATHWAYS

Critical analysis of a research paper is the process in which the truthfulness, reliability and validity of the overall content presented in the research paper are analysed. This essay is going to present a critique of the given qualitative research paper, “Patient experience of centralized acute stroke care pathways”. The essay is going to use the critical appraisal tool developed by Calvin Moorley to make a critical evaluation of each section of the research paper. The topic is highly important in the modern nursing field that allows registered nurses and other nursing professionals to understand the benefits of centralised acute stroke care services to patients who suffer from hyperacute strokes. Through selecting the research paper for critical evaluation, this essay is going to provide insight on the fact that how centralised care process regarding the treatment of patients experienced an acute stroke will allow modern nursing professionals to conduct better patient-management and provide holistic as well as compassionate care to patients. In its body, the essay will present a critical analysis of authors’ credentials, abstract, methodology, literature review, data collection and finding of the qualitative research paper. In the conclusion part, the essay will summarise the important underlying aspects of the entire discussion.

While it comes to present a critical analysis of any research paper the first thing that comes in place is to evaluate the authenticity of the writing, abstract, authors credential and title of the research paper (Kerans et al. 2020). The title of any research paper presents the concise explanation that gives the reader an idea regarding the subject on the entire content. Therefore, the validity of a research paper-dependent son how relevant as well as appropriate is the title to the subject of the research paper. Here the qualitative research paper has a concise and appropriate title that highlight the objectives and aim of the entire research paper. Through the title of the given research article is clear ta the research paper is going to discuss the benefits, impacts and limitations of acute stroke care services in London and Great Manchester. As argued by Thon and Jucks (2017), while analysing the authenticity ad validity title of a research paper it is not sufficient to analyse only the relevance of the title to the underlying content of research paper, rather its is also need to analyse whether the words used in the title are justified as well as valid based the purpose and objectives of the research. In this context, it can be stated that here in the qualitative research the title has used appropriate and justified words which makes simple but valid title that allows the reader to understand the purpose and aims of the research paper.

Another important aspect that needs to considers while presenting a critical analysis of any research paper is the credentials of authors. As mentioned by Dale et al. (2019), a research paper must mention the educational qualification and academic backwound of each of its authors that is important to ensure the validity as well as reliability of the research study. In the qualitative research paper, there are mentioned about the academic qualifications and educational background of authors that highlights the fact that each author of this research study is eligible for conducting the research study. As argued by Thon and Jucks (2017), sometimes, despite having required academic qualification authors are unable to meet the desired goals of the research study due to other factors such as lack of investiture for conducting successful research, time insufficiency and fund shortage. Despite the criticism regarding the concept of analysing authors' credential for analysing the validity of any research paper, many studies have acknowledged that reliable and successful research is that in which the authors have an academic qualification that is important for researching systematic way. Here the qualitative research paper has successfully mentioned the educational qualification of its authors which present the validity as well as reliability of entre research study.

While presenting a critique of any research article, the abstract is another important section that needed to be considered. As stated by Athens et al. (2017), abstract of any research paper present the summary of the research study that assists the reader to understand the aims, objectives, research process and the finding of the research study. In the given qualitative research article, there is a clear abstract which presents an individual section of the research study that is important to know about the aims and finding of the entire research. These sections are background, objectives, research aims., participants. Research design, finding and conclusion. The background part of the abstract presents the reason and context based on which the entire research has been conducted. In the background section, the abstract mentioned the fact that centralised acute stroke care services are provided to patients to reduce the vulnerability towards rusk of hyperacute stroke. On the other hand, there is mentioned a clear objective in the abstract section which mention the research study aims to; provide insight on the impact on centralised acute stroke care system on the healthcare experiences of patients. In the abstract there is mentioned that here researcher has used the qualitative interview with implementing deductive and inductive approaches. Additionally, in the given qualitative research the abstract presents clear findings and conclusion part. In findings part of the abstract there is a brief but clear summary of experiences that patients received due to implementation of centralised acute stroke care system on them throughout the research study. Finally, the abstract of this qualitative research presents a small conclusion of the entire research study that assists readers to have an idea about whether the research study has successfully met its desired goals. As mentioned by Caldwell and Bennett (2020), abstract of a research paper needs to be concise, clear and relevant that will allow the reader to make a clear concept not only on purpose and design of entire research study but also on its finding and analysis. On this note, the qualitative research paper has a clear and brief abstract that has summarises the crucial points of the research study are enough for readers to have a clear overview of the entire research study.

As stated by Erlandsen et al. (2018), during evaluating a research paper critically, it is important to consider whether the research paper has a clear research rationale. A successful research article must have a clear rationale which will present the context as well as reason based on which the research study has been conducted. As mentioned by Impens (2018), the rationale of any research not only highlights the purpose of conducting a particular research study but also present whether the research study is relevant to the modern context. Research rationale is one of the most important sections of any research paper that presents the aspects on which researchers intend to emphasise throughout the research. On this note, in the given qualitative research paper there is no clear research rationale or purpose that raises questions validity, authenticity and reliability the research paper. On the other hand, the research paper does not mention any problem statement at the beginning of the research article which makes it's obscure that what are the basic issues or problem that are going to be encountered by the researcher through conducting the research study. As mentioned by Mohajan (2018), successful and valid research will mention the research problems that are solved through conducting the research study. On this note, the absence of a clear rationale and problem statement on the given qualitative research article interferes with its authenticity and validity that can pose potential goals.

The literature review is an important section of any research paper both qualitative and quantitative while it comes to present a critique of the research paper. As stated by Snyder (2019), a successful as well as valid research article must have a well-constructed literature review that presents a clear as well as in-depth evaluation or review of research article regarding the selected research topic. A good literature review will present a summary or synopsis of previous researches on selected topic thereby highlighting how much the research topic is important in relation to the current context. On this note, in the given qualitative research paper there no literature review which interferes with the quality, truthfulness and validity of the research paper. On the contrary Hopia et al. (2016) argued that, in many cases, the researcher has limited access to article and journals due to fund and time insufficiency, that makes them unable to present a well-constructed as well as a clear literature review that sometimes interfere with the quality of the research article. . On the other hand, it is acknowledged by many studies that in presenting a valid and qualified research paper it is crucial to mention and individual literature review section which ensures that the qualitative and quantitative database used by the researcher to meet the research objectives are valid and evidence-based. On this note. Lack of well-constructed literature review in the given qualitative research raises a big question on the validity, authenticity and quality of the qualitative database that is used in the research paper to discuss the research topic.

A well-structured research paper must mention clear aims objectives and design of the entire research study. As mentioned by Lohan et al. (2017), while conducting a critical analysis of research article, research aims, objectives and study design are considered as the important parameters that measure the validity, quality and authenticity of the research study. Here the qualitative research article has a clear section that mentions research aims and objectives. This section highlights that the qualitative research study sim to explore patient’s experiences regarding the centralised acute stroke care service in London and great Manchester. This section also mentions that the objective of this research study is to determine the usefulness as well as limitation of centralised acute stroke care services for patients who experiences a hyperacute stroke. Study aims and objectives of this research study highlight the fact that here researcher is going to explore the experiences of patients throughout their journey to emergency care unit, the hyper acute stroke unit (HASU) and local stroke unit while receiving the centralised acute stroke care service. As mentioned by Carson-Stevens et al. (2016) if any research article has successfully mentioned its aim and objectives article then it is considered as a well-constructed and reliable research paper. On this note, it can be stated that as the qualitative research paper has clear aims and objectives it enhances the level authenticity and validity of this paper.

Research design is one of the most important aspects that needed to be considered while analysing any research paper. Study design mentioned the overall process and pathways in which the entre research is going to be conducted (Mohajan, 2018). Qualitative research generally uses phenomenology research design. Phenomenology study can be defined as presenting people’s own perspectives, understanding and perception on any particular situation (Van Manen, 2017). Through using the phenomenological research design researchers are enable to make an in-depth analysis of experiences and understanding of the participants in relation to the research questions. Here in the qualitative research article, the phenomenology research design has been used by researchers to analyse the perspective, experience and realisation of the selected stroke patients about receiving the centralised stroke care. As mentioned by Qutoshi (2018) the phenomenological research design has descriptive and indicative research approach that are developed from the phenomenological philosophies. The authors also mention that the aim of this phenomenological philosophy is to present the experiences as well as understanding of the people that they gather from living a particular situation. As mentioned by Van Manen (2017), the phenomenological design is on the paradigm of personal knowledge as well as subjectivity that generally emphasize on the personal interpretation and personal perspectives. Here the qualitative research does not have any discussion on type of the research design that is selected in this paper. Although through analysing the description and analysis of the data, it is clear that here phenomenological research design has been used to present the real-life experiences and realisation of selected stroke patients. As argued by Qutoshi (2018), a good research design has clear discussion on how the selected research has assisted researchers to present the database. However, this qualitative article lacks the discussion on why the phenomenological research has been selected and how it helps the researcher to meet their objectives, which can be considered as the potential drawback of this research paper. Through analysing the database, it can be stated that in this research article, phenomenological research design assists the researcher to get the powerful understanding on subjective experiences of participants to gain deep insight on the activities, motivation and behaviour of the participants. Here the although the qualitative research paper mentioned it its abstract section that qualitative interview has been conducted by the researchers in which inductive and deductive research approaches are implemented, in the main body of the research paper there is no clear discussion about these techniques and methods which interfere with the quality and validity of the research study. As argued by Taherdoost (2016), a good research design will not only mention the techniques and methods used by researchers to conduct the study but also will discuss the experimental hypothesis. On this note, in this qualitative research paper, there is no discussion on the experimental hypothesis that raise questions on the validity and authenticity of the process through which the research has been conducted.

In any research paper the first important ethical aspect is the ethical approval, in which the concerned ethical research committee checks that whether the researchers follow all the research ethics and ensure that there are no chances of harm to the human subjects. Here the qualitative research paper mentions that it has successfully received the ethical approval from London East NHS Research Ethics Committee (Ref 11/LO/1396 during September 2011. As mentioned by Ryen (2016), in getting the ethical approval, the researches need to ensure that the participants are free from any kind of discrimination, bias, humiliation force and maleficence. The second important ethic is informed consent from the participants. Here the qualitative study has mentioned that the participants who are able to provide their valuable informed consent are selected for the study. The third research ethic is participants’ autonomy as well as preference. However, there is no discussion in this research paper about the autonomy and preferences of the participants that can raise the question on it’s validity and authenticity. The fourth important research ethic is confidentiality, in which researcher must ensure that the participant’s personal and professional information will be confidential. Here this research does not mention anything about the confidentiality which poses question on the validity of the research. As mentioned by Dooly et al. (2017) researchers must ensure the non-maleficence, data transferability, and beneficence of the data throughout the research. On this note, it can be stated that, although the research paper has received the ethical approval before conducting the study, authors do not present a comprehensive discussion on the ethical considerations on how all the ethical aspects are implemented as well as followed by them throughout the research study. Therefore, the lack of proper information in ethical consideration section of this research paper interferes with the quality and standard of the research study.

A well-structured research article must have a clear discussion on sampling techniques, population size and type of sampling method (Taherdoost, 2016). Sampling process is the most crucial for any research in which researchers select the suitable participants from a large population pool based on the selection criteria. Here the qualitative article clearly mentions that researchers have used non-random purposive sampling process to select the participants. Non random sampling techniques can be defined as the process in which the sample selection is based on the pre-determined selection criteria for a specific purpose (Taherdoost, 2016). In this sampling technique there is no system of the sample selection. In this study the sample is not selected as the random proportion if the population rather, the researchers have selected the population based on the prefixed criteria, such as the patients must experience the stroke for being eligible for this data collection, in addition to this, the participants must have the enough cognitive ability so that they can understand the research question can answer them properly. As mentioned by Lohan et al. (2017), non-random sampling process has several types such as convenience sampling, quota sampling, purposive sampling and snow-ball sampling. Here in the qualitative articles the paper clearly mention that purposive sampling process is used in terms of collecting the data from participants. According to Mohajan (2018), purposive sampling is the process in which participants are selected based on their ability to elucidate specific phenomenon, concept or theme. Here the qualitative research paper mentions that a total of 36 stroke patients is selected purposively for conducting the qualitative interview process. Here the qualitative research paper has clearly mentioned that purposive non-random sampling has been used by the researchers to select valuable participants. Here recruitment of 15 stroke patients is conducted from 3 hospitals in Great Manchester and 21 stroke patients are selected from 4 hospitals in London. Additionality the research paper also discusses the how these selected patients go through the centralised acute stroke pathways such as admission to HASU, then admission to the local stroke unit and then discharge from the local stroke unit. As argued by Basias and Pollalis (2018), while evaluating the sampling techniques of a research paper it is also important to evaluate that whether researchers meet the recruitment criteria while selecting participants for the data collection process. In this qualitative research paper, although the paper has mentioned the population size and sampling type, it is failed to make clear discussion on the criteria that researchers have used while recruiting the participants, on this note, it can be stated that although the qualitative research paper can present a clear and well-structured sampling method, lack of information on recruitment criteria can raise the question on the validity of the participants' selection process.

Data collection is an important part of any research. A well-constructed research article will mention the data collection process, in which data are collected from participants. As mentioned by Zangirolami-Raimundo et al. (2018), a research paper must make a comprehensive discussion type if data collection process, the criteria that researchers have followed while collecting data and the time when which data are collected. Here the qualitative research paper has mentioned clearly that data collection has been conducted during 2013. The data collection segment of this research paper also mentioned the systematic process in which patients are approached in hospitals and data are collected. The research paper has discussed that patients are approached before their discharge from acute stroke units of the hospital. Here the research nurse and doctors provide an information sheet to the patients and their family members to inform them regarding the purpose of the research study. As mentioned by Basias and Pollalis (2018), a well-structured research article would mention the types of data collection process and its relevance to the research goals. Here the research study mentioned that semi-structured interview has been selected for data collection which allows the researcher to record the individual experiences as well as the emotion of patients regarding receiving the centralised stroke care service. The research article also mentioned that patients are interviewed after 3 months of their discharge at their home. Carers are allowed to be present with patients while the interview is conducted to make patients feel relaxed and safe. From this discussion, it can be stated that this qualitative research has successfully mentioned the well-constructed data collection process that ensures the validity and authenticity of collected data.

Data analysis and finding are important section of any research paper that acts as an important parameter of measuring the validity and quality of research paper. Here the qualitative research paper has successfully mentioned that patients’ experiences on receiving the centralised acute stroke care were positive. The qualitative research article has a clear finding that shows that centralised care for stroke patients can improve care experience of stroke patients. Here the findings have contributed to the knowledge on patients experiences of centralised acute care services the data also demonstrate that the overall patients’ experiences provide the crucial and valuable information regarding how a care service is operated. Here the findings that researcher have gathered are relevant to centralisation of any kind of care services that involve the patients to be taken to more distant care delivery service and then repatriated back into a local service. The findings show that centralised stroke care provides to patients in hospitals of London and Great Manchester improved the health and wellbeing of patients. This centralised care process is highly useful in providing information to patients regarding their self-management that can improve their quality of life. The backdrop of this centralised acute stroke care service is the travelling of patients from one emergency unit to another stroke unit can outweigh their chances of getting the best quality and compassionate care. Therefore, the research paper successfully mentioned both the benefits ads drawbacks of the centralised stroke car system which enhances the validity, reliability and truthfulness of the entre research study.

From the overall discussion, it can be concluded that while making a critical analysis of any research paper, it is important to use a systematic process to analyse each segment of the research study. During the critical analysis of reteaching paper, credential of authors, abstract, ethical consideration, literature review, data collection, data analysis and finding the need to be evaluated. These segments act as the important parameter that determines the level of validity, quality, accuracy and reliability io any research paper.

Dig deeper into Patient-Centred Healthcare with our selection of articles.

Reference list:

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