Critical Appraisal of 'An Exploration of the Hydration Care of Older People

Introduction

The essay is going to present the critical appraisal of the article named “An exploration of the hydration care of older people: A qualitative study” by Godfrey et al. (2012). Critical appraisal is the process of systematically and carefully examining the research to determine and analyse its value and relevance in particular context along with its trustworthiness and credibility (Al-Jundi and Sakka, 2017). The structure to be followed in presenting the critical analysis is that initially the definition and importance of evidence-based nursing is to be discussed. Thereafter, the outline of the chosen research paper is to be presented along with rationale of the choice. The CASP framework is to be used for further critical appraisal of the article in which its methods, results, ethical consideration and others are to be appraised to determine its value and relevance to the topic presented. Further, the summary and recommendation based on the findings and conclusion is to be discussed. The topic under consideration that is hydration care in elderly is been explored because dehydration caused by imperfect hydration care is one of the common health issues found in older people which creates subtle impact in deteriorating their health. This is evident as nearly 20% of the elderly in the UK are seen to suffer from dehydration and it causes confusion, weakness, urinary tract infection (UTI) and others in them (nutrition.org.uk, 2019). Thus, the topic is significant to be explored so that the issues leading to hindered hydration care and strategies to be taken in the case to ensure between well-being of the elderly can be explored.

Discussion

The evidence-based practice is the conscientious, problem-solving approach in clinical practice that includes the incorporation of best scientific evidence from well-designed and logically-framed studies for making expert decision regarding quality care of the patients (Lamb et al., 2019). In the current health and social care environment, where various complex health issues are to be managed by the nurses and high demand for quality care with no to less error are demanded, the evidence-based practise (EBP) is considered as a significant approach to be used. This is because EBP help the nurses to explore evidence regarding complex care that has been previously provided to patient with similar health issue, in turn, educating them about the skills and knolwdege to be needed in delivering specific care to the patient. It helps the nurses to make evidence-based decision to determine the way right care with quality to be delivered without error (Ratish, 2019). The chosen paper to be critically appraised in developing evidence-based practise is ““An exploration of the hydration care of older people”. The mentioned paper is chosen because dehydration issue is one of the major health problems been faced by most of the elderly. This is because of their susceptibility to water imbalance in the body out of insufficient drinking which create a key issue for the nurses to ensure quality health condition for the elderly (Białecka-Dębek and Pietruszka, 2019). However, the factor which promotes dehydration and hindered hydration care to the elderly is unknown. The current paper highlights the complexity and issues responsible in dehydration and hindered hydration care in the nurses (Godfrey et al., 2012). Thus, its appraisal would provide insight into the cause of the hydration care problem in elderly, in turn, would help to determine the factors to be resolved for enhanced hydration that ensure between well-being of the elderly.

The CASP qualitative framework is been used in critical appraisal of the article because it is a simple tool and allows effective analysis of relevance and value to the research in systematic manner by follow ten key questions (CASP, 2018). The CASP framework mentions that a clear statement of the aim of the research is to be present (CASP, 2018). In the study by Godfrey et al. (2012), a clarified aim in the study is been presented which is evident as it mentioned the aim of the study is to understand the complexity of problem-related with the hydration care and hydration of elderly. The presence of clarified research aim is significant and strength of this study because it allowed to effectively express the intention of the research and the facts to be learned at the end of the study which helps to determine its usefulness in relation to the topic been explored by the reader (Bell et al., 2020). The CASP mentions to identify if the qualitative methodology is appropriate to be used in relation to the study (CASP, 2018). The qualitative methodology imparts knolwdege about the in-depth understanding of the way people express any habit, understanding and manage their everyday activities (Squires and Dorsen, 2018). In the current study, detailed explanation regarding hydration habits and the issues created by elderly in acceptance of hydration care as well as hydration care delivery hindrances faced by nurses is to be understood. This is possible to gather with in-depth explanation and assessment of feelings and attitude of the elderly patient and nurses which can be identified through use of qualitative ways and therefore, the qualitative methodology use is appropriate in the study. The CASP mentions if research design appropriately related with the aim of the study (CASP, 2018). The study by Godfrey et al. (2012) used multi-method qualitative study design which is appropriately related to the research aim. This is evident as the multi-method qualitative design used would allow gathering of varied data from different sources to present multiple details with clarification derived from discussion with the participants about complexity of hydration and hydration care in elderly that is the aim of the study.

According to CASP framework, the appropriateness of the recruitment strategy in relation to the aim of the study is to be evaluated (CASP, 2018). The study by Godfrey et al. (2012) mentioned that recruitment strategy followed the inclusion criteria of allowing patients above 65 years and nurses who have provided care regarding hydration to participate and exclusion criteria included patients who did not provided informed consent or are too ill to participate. The recruitment strategy is appropriately related to the aim of the study because it allowed recruitment of elderly patient that is the focused population. Moreover, recruitment strategy is related to the aim as it ensured participation of specific patients and nurses who are related to the care condition and can provide effective insight regarding the research topic. The CASP framework mentions to evaluate if data collection is done in a way that address the issue in research (CASP, 2018). The data collection way used in the study by Godfrey et al. (2012) is appropriately related to address the raised problem in the study. This is evident as the study used all the possible qualitative methods of data collection such as interview with the elderly patient, focus group discussion with staffs, suggestion from relatives through comment box and observation of hydration care action that allows gathering detailed and appropriate information which explains complexities involved in hydration and hydration care for the elderly. The CASP mention that relation between the researcher and participant are required to be adequately considered (CAP, 2018). In the study by Godfrey et al. (2012), relation between the participants and researcher was adequately considered as the researcher were seen to critically examine their role and potential bias to be faced while executing the study. The CASP mention to identify if the ethical consideration is been followed in the study (CASP, 2018). The study by Godfrey et al. (2012) appropriately followed all the ethical considerations in the study. This is evident as the researcher after gathering informed consent from participants and ethical approval from the and Faculty Research Ethics Committees, University of the West of England and the Frenchay Research Ethics Committee executed the study. Thus, it helped the researcher to ensure all the actions taken in executing the research was done morally and no legal obligations were avoided to be followed that ensured no legal actions been faced in the study. The CASP framework mentions to determine if the data analysis is been sufficiently rigorous (CASP, 2018). The study by Godfrey et al. (2012) ensures the data analysis is been rigorously presented as it used thematic data analysis and mentioned in-depth the way themes are derived. This is evident as the study mentioned the researcher initially by developing familiarity with the collected data from transcripts, suggestion box and others developed the themes and presented data under specific themes. Moreover, it mentioned they used NVivo8 program in handling and coding data to be presented under themes. The study by Godfrey et al. (2012) also mentioned the way rigour in the study is been followed which ensure way credibility trustworthiness and dependability were achieved in the study is been mentioned. This is evident as the study mentioned it ensured credibility by increasing engagement of participant in the settings to get immersed in the data to capture the true essence of the hydration facts from elderly and by performing multi-method action that added to the richness of the study. The transferability is ensured by explaining way settings and sample is been collected to let the reader determine way they can use the data to be transferred to other settings. The trustworthiness is the study is also assured by creating audit trail and mentioning way data collection is been done.

The CASP mentions that clear statement of findings is to be presented (CASP, 2018). In the study by Godfrey et al. (2012), clarified statement of findings are present by relating with the aim of the study. This is evident as the study mentioned limited aesthetic practise, lack of focus on fluid consumption and lack of pleasurable along with social experience regarding drinking were issue faced by elderly that resulted in their hindered hydration practise. Moreover, the findings mentioned that verbal promoting, placing drink in hands of patients, offering choice and assisting in drinking are hydration care required for enhanced hydration of the elderly which are key focus to be identified as per the research aim. The CASP framework mentions to determine to what extent the research is valuable (CASP, 2018). The study by Godfrey et al. (2012) mentioned in detail the way the study would contribute to the existing knowledge or understanding regarding the topic. This is evident as the study mentioned the facts presented could be used as basis to educate relatives and friends taking care of the elderly patient at home to understand way to take actions in promoting enhanced hydration of the patients. However, it did not explain new areas where further research is required. In the study by Godfrey et al. (2012), the findings are robust enough to support nursing practise regarding hydration care for elderly patients. This is because the data explained the specific hydration care actions to be taken by the nurses and way they are to be achieved to ensure quality hydration of the elderly. The finding in the paper by Godfrey et al. (2012) would contribute in professional development of nursing practice by making the nurses aware of action that leads to dehydration in elderly patients. Moreover, it would help the nurses to develop skills and knolwdege regarding the way drinking behaviour of elderly is to be influenced along with the way the nurses are to act in setting to deliver appropriate hydration care.

Conclusion

The above discussion mentions that dehydration is a key health condition faced commonly by elderly and issues in hydration care by nurses has made it worsened. The study by Godfrey et al. (2012) explored effectively the issues of hydration in elderly and mentioned in detail the way hydration care is to be delivered and issues that lead to dehydration in elderly to be controlled. The study used qualitative design and according to critical appraisal by CASP ensured most of the criteria of valued research have been met. It ensured the study could be used in evident-based practise by nurses in delivering hydration care to elderly patients. One of the recommendations is that further delineation of the social and behavioural aspects regarding health intervention for promotion of hydration care in elderly is to be made. This is required so that more effective approaches to support hydration care is been developed and it is to be achieved through further expansion of the research. The other recommendation is that nurses are to get training and education regarding the way hydration devices and technology is to be used to empower elderly to develop self-dependence in managing own hydration. This is because it would help to lower burden of care on the nurses and make elderly feel greater value to be able to manage at least one vital aspect of their care.

References

Al-Jundi, A. and Sakka, S., 2017. Critical appraisal of clinical research. Journal of clinical and diagnostic research: JCDR, 11(5), p.JE01.

Bell, E.A., Cleland, J. and Gambhir, N., 2020. ‘It clarified a lot’: GP trainees as peer role players in a formative Clinical Skills Assessment (CSA). Education for Primary Care, pp.1-6.

Białecka-Dębek, A. and Pietruszka, B., 2019. The association between hydration status and cognitive function among free-living elderly volunteers. Aging clinical and experimental research, 31(5), pp.695-703.

CASP 2018, Critical Appraisal Skills Programme, Available at: https://casp-uk.net/wp-content/uploads/2018/01/CASP-Qualitative-Checklist-2018.pdf [Accessed on: 08 April, 2021]

Godfrey, H., Cloete, J., Dymond, E. and Long, A., 2012. An exploration of the hydration care of older people: a qualitative study. International Journal of Nursing Studies, 49(10), pp.1200-1211.

Lamb, C., Evans, M., Babenko-Mould, Y., Wong, C.A. and Kirkwood, K.W., 2019. Conscience, conscientious objection, and nursing: A concept analysis. Nursing ethics, 26(1), pp.37-49.

nutrition.org.uk 2019, Dehydration in the elderly, Available at: https://www.nutrition.org.uk/nutritionscience/life/dehydrationelderly.html [Accessed on: 08 April, 2021]

Ratish, S., 2019. Evidence-Based Practice-A Key to Quality Patient Care. International Journal of Nursing Education and Research, 7(4), pp.638-642.

Squires, A. and Dorsen, C., 2018. Qualitative research in nursing and health professions regulation. Journal of Nursing Regulation, 9(3), pp.15-26.

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