The research report caters to the study presented by Lui, L Y Y, So, W K W and Fong D Y T (2008) Knowledge and attitudes regarding pain management among nurses in Hong Kong medical units. Journal of Clinical Nursing, 17(15): 2014??021.
Introduction
The research deals to pain management implying in knowledge and attitudes placed by several nurses at HK medical units and that research is on the right notion as there shows factors influencing nurses’ attitude and knowledge about pain management. Agreeing to the proponents of the research report that pain assume such common symptom for patients in medical units and be ideally relieved through effective pain management and supporting to the assumption that nurses play a crucial role for executing pain management with effectiveness and realizing the fact that these nurses should be able to integrate solid foundation of knowledge as well as attitude towards pain management in a positive manner. Supporting to the statement that, nurses should have solid foundation of knowledge about pain management and develop positive attitude towards it to assess patients’ condition and to deliver individualized care to each one so as to reduce discomfort and enhance the quality of life.
The wider methods capacity is being found into application of descriptive statistics and stepwise regression as used in achieving research data analysis. The detailed research analysis and report have to be detailed for the readers to learn and nursing practice research does incur methodological approach which affirms accurate and reliable findings of the situational patterns being studied from where outcomes does adhere to greater heights of validity stance. The arguments about merits of qualitative research, varieties of qualitative methods, the lack of clear boundaries between quantitative and qualitative research, the tendency to evaluate qualitative research against conventional criteria of rigor and core features of qualitative inquiry.
Discussion, Critique and Analysis
The methodology can possibly be mixed up with several case study situations from wherein narrative inquiry towards pain management are being assessed accordingly, as there arguments that pain management are being known from within use of several research methods as grounded into comprehensive theoretical and pragmatic framework in nursing research and findings are to be discussed, analyzed and at the same time be interpreted with consistency of information and research evidence implying to the success of research undertaken for a more meaningful nursing care practice. Furthermore, outcome analysis can take place at several degree wherein research theories and paradigms are combined and integrated in order to form innovative research design and process endeavors. In addition, case study can be ideal in research for pain management noted by the nurses, as the researcher will have to uncover more variables than he have on research data points, making statistical control a possibility and the identification of causal influence as being operationalized into the study, (Creswell, 1994, p. 144) also helpful in generating hypotheses and theories in developing comprehensive research towards pain management in knowledge and attitudes inquiry of nurses at medical units.
The research design found in research maybe fine but it does not come up to the appropriate method to used according to research focus, as the design is just limited to some type of cross sectional study, even though self administered survey is of ample relevance when utilized mostly for health and medical study purpose, as primary research will not be noted properly without secondary information support, there was enough organization and administration of the methods incorporated in the report wherein there places to the nurses’ knowledge and attitudes survey regarding pain Chinese version (NKASRP-C) as being completed by 143 nurses working at medical units in HK public hospital. For instance, in the report acknowledging Dix et al. (2004, Lui, So and Fong, 2008, p. 2014) have evaluated the prevalence and severity of pain in the general medical setting. There was about 887 patients reporting pain, 52% (Lui, So and Fong, 2008, p. 2014) were patients on medical wards, 20% (Lui, So and Fong, 2008, p. 2014) reported severe pain and 12% experienced unbearable pain. Thus, Strohbuecker et al. (2005, Lui, So and Fong, 2008, p. 2014) evaluated the prevalence of pain in 561 hospitalized patients. Truly, pain management assume essential aspects of patient care and is relevant to the nurses, Cohen (1980, p. 1, Lui, So and Fong, 2008, p. 2014) noted that ‘although medical staff are accountable for prescribing analgesia, much of the responsibility for the comfort of patients rests with the nurses’.
The one issue may recognize that few of HK nurses does really understand patients’ needs for pain management such as during and after hospitalization as there increases to awareness of how nurses in medical units should deal and communicate to patients in order to achieve effective management of pain. The research design needs to be revealed as some of the nurses may determine unmet needs in managing pain according to care and mode of service to patients as the report findings motivated the critical importance of nursing research. There needs to be utilization of several pilot study for overall theme assimilation and linkage of conceptual as well as theoretical framework, there can be several research noted concerns for example, the need for in-depth knowledge and method information as well as the finding in of appropriate literature resources.
Furthermore, research specifications does reinforce the critical aspect of certain comprehensive pain management upon addressing the needs of possible underserved nurses population and that, those nurses responsible for pain management will need awareness of the risk factors such as hospitalization, adverse effects of medication and the lack of evidence based knowledge and methods paradigm. Thus, the report may have used limited sample size and arising of challenging issues in pain management occurs promoting in patient safety and ideal care service. There must be detailed research literature (Steward, 2004, p. 495) and evidence points in order to help inform that research design is of vital structure of every nursing research being put in spontaneous practice and methods application. The need for a more organized and systematic literature support of pain management as the literature does provide comprehensive account of research done in support to the journal, being imperative to integrate critique of a particular report engaging enough amount of research significance, rationale as well as relevance regarding knowledge and attitude of nurses towards pain management. Supporting in effective utilization of research methods in form of qualitative and quantitative resources, there is sort of descriptive research and process along with the inclusion of self administered questionnaires for possible analysis and conforms to the high end primary research (Creswell, 1994).
In addition, responses may linked into possible agreements and disagreements of the survey as the research outcomes presented did show standard frequencies and percentages of the results analyzed from the methods found in research context, although certain sample sizes are too vague to interpret in specs but there can be medium to research contribution into professional nursing work and practice. There has to be recommendations that research design as well as methodology should be able to facilitate the discovery of quantifiable information as in methods triangulation, as argued that if nursing scholars limit themselves to one method of enquiry, possible restrictions will be placed on the development of nursing knowledge from the composed studies about shift work and its related domains (Steward, 2004). For nursing practice manifested into the journal being critiqued, the arguments into nature of knowledge recognized by applied methods and how such nursing related articles/journals should be critiqued in whole sense as it is not possible to judge qualitative research by using conventional criteria also conclusion and agreeing that, there needs to be in operational stature in order to take account distinctive purpose of the articles in research form.
The journal chosen contribute positively to nursing research from which current studies are significant from professional viewpoint and that nurses management of pain are manifested as one better factor to deal about patient care success in medical units and healthcare setting nowadays and because the proponents concepts are of positive stature, nursing research emphasize a better foundation of nursing practices and its underlying professional domain, improving in Hong Kong medical care areas, the inclusion of research approach from where reliable observations and study information is being emphasized into logical and acceptable manner allowing in appropriate research base of pain management as connected within the totality of nurses service and HK care practice. The need for enough generalizability and better research domains as ideal settings for the sample size to respond well from within clear methodological organization, presence of valid, reliable research instruments as utilized impeding in causal issues among nurses ethical formation and service commitment despite pain management problems integrating in useful critical thinking as there found good reasoning and reflective, rational thinking based on literature knowledge and there is enough analysis of the available information and ideas. Nursing practice mandates the use of extensive critical thinking skills within the nursing process as it enhances clinical decision making, helping to identify patient needs and to determine nursing actions towards pain management.
Research spontaneity is effective factor for recognizing systematic accounts of the factors to support research studies from methods used and be objective for undergoing empirical research as shortages into the nursing practice can truly be a sad reality put into subjective terms. In addition, most methods found utilized to achieve representative samples depend, in some way, on the process of random assignment. Random sampling is the selecting of random sample such that each member of the population has an equal chance of being selected (Creswell, 1994). Thus, surveys fall into analytical and descriptive from where article’s inclusion of research rigor will allow effectiveness of results. In contrast, descriptive surveys tend to use an inductive approach, often using open-ended questions to explore perspectives. Descriptive technique may be quite ethnographic in character, it is important to establish the research’s frame of reference. Nurses maybe amenable to answering personal and delicate questions through such anonymous medium (Creswell, 1994), it is possible that answers may be more honest than when faced by an interviewer, whom they may be tempted to impress by exaggerated responses and from socially desirable response.
Aside, questionnaires should be used when they fit the objectives of the research from the articles known, several data analysis of closed questions is relatively simple and questions can be coded quickly in order to recognize the responses of nurses and presence of feasibility posits in order to ensure appropriateness of content reflecting in research assimilation (Creswell, 1994). Ideally, it is necessary to integrate research methods into evidence posed by findings as due to engaging techniques of collating points from wherein surveys, questionnaires and interviews adhere to methods triangulation and are found as better choices into the overall contribution of knowledge into nursing practice in desirable research foundation. The proponents are good critical thinker as the authors used reality based deliberation to validate the accuracy of research from within reliability of resource; indicative interpretations are good enough to determine pain management significance from the methods used, conducting of qualitative studies places desire to collect information to capture article elements to make it in interpretive validity as attributed to certain responses made by selected nurses and the extent to which findings can be generalized beyond nursing care as generated.
Conclusion
In conclusion, there was better understanding of pain management factors that affect nurses’ knowledge and attitudes and of the discrepancy between research and evidence do provide useful information to be included in nursing education programs and to inform policies into managing pain pathways. There assumes learning that nurses must use critical thinking skills in the nursing care, regardless of actual care as patient situation is viewed as dynamic as there imposes tabulated interpretations of research, allowing nurses to focus on factors that are relevant and significant to pain management in lieu to organized plan of action. Truly, research evidence is to have valid literature points as the study deals to adverse physiological and psychological effects of shift work and the inclusion of certain situations such as health problems and diminished performance at work.
Therefore, agreeing that the report did provide what is thought to be primary information about the knowledge and attitudes in relation to pain management of the nurses working in HK medical units and it is a fact, that knowledge deficit among nurses in pain management is presently alarming indeed, diverse strategies is to be realized to achieve quality of life. The critique did provide ample basis for good research positions as for instance, diverse methods recognized in the articles found to have strength in parallel to research context and paradigm as when executed, will add innovative nurse perspectives to pain management for further investigation. The kind of knowledge presented hereunto, should not be seen as ranked but as fairly valid and necessary to achieve appropriate illustration of pain management provided by nurses as there are issues to determine and resolved through research idealism.
References
Cohen FL (1980) Post surgical pain relief: patients’ status and nurses’ medication choices. Pain 9, 265–274
Creswell JW (1994) Research design: Qualitative and quantitative approaches. Thousand Oaks, California: Sage
Dix P, Sandhar B, Murdoch J & MacIntyre PA (2004) Pain on medical wards in a district general hospital. British Journal of Anesthesia 92, 235–237.
Lui LY, So WKW and Fong D Y T (2008) Knowledge and attitudes regarding pain management among nurses in Hong Kong medical units. Journal of Clinical Nursing, 17(15): 2014??021
Strohbuecker B, Mayer H, Evers GC & Sabatowski R (2005) Pain prevalence in hospitalized patients in a German university teaching hospital. Journal of Pain & Symptom Management 29, 498–506
Steward B (2004) Writing a Literature Review. British Journal of Occupational Therapy 67(11), 495-499.
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