EBP-Task 1

PART A

Barkish, F. G., Jalali, R., & Jalali, A. (2019). Experiences of patients with primary HIV diagnosis in Kermanshah-Iran regarding the nature of HIV/AIDS: A qualitative study. Heliyon, 5(8), e02278. https://www.sciencedirect.com/science/article/pii/S2405844019359389

The essay is an evaluation of a qualitative research article by Barkish et al., (2019), “Experiences of patients with primary HIV diagnosis in Kermanshah-Iran regarding the nature of HIV/AIDS.” The article has significant relevance to nursing and healthcare practice at large as it focuses on a chronic condition with worldwide prevalence. The article was published in a reputable website that orates issues of concern and utmost interest to nurses internationally, which makes it specifically insightful in the HIV/AIDS and nursing practice in a global context.

A1.  

Background or Introduction: 

The authors have easily and unequivocally located the problem statement in the first line of the second paragraph of the article. The researchers’ focus is on the complications and stressful experiences associated with diagnosis of patients with HIV/AIDS from the victims’ point of view (Barkish et al., 2019). Indeed, this problem is significantly relevant for nursing practice as it directly impacts the life expectancy of patients living with HIV/AIDS. The study has a clearly convincing and persuasive purpose as it focuses on interpersonal factors, which are of significant importance for improving the patient-nurse relationship quality. It is critical to study such aspects to identify the drawbacks and mitigate them to so as to improve the psychological, emotional, and physiological health of patients living with HIV/AIDS. The researchers have correctly matched the qualitative paradigm with the research problem. The researchers have explained the life experience of patients living with HIV/AIDS during primary diagnosis in regards to their expectations concerning the quality of care. 

Literature Review: 

The researchers have adequately summarized the previous studies touching on the phenomenon of perception of HIV and its impacts on patients’ quality of life after receiving a positive diagnosis. The authors have clearly pointed out the existing gaps in previous studies. The article identifies that no conducted studies have touched on the nature of HIV diagnosis regarding the residents of Iran (Barkish et al., 2019). The researchers acknowledge the need for taking in-depth interviews on the residents who are the primary source in order to understand their plight, examine the attitude and interpretation of the residents on positive diagnosis, improve the relationship of the residents living with HIV with their nurses, and improve the quality of care.

Data analysis:  

Data analytical approach involved notes taking and summary by the interviewer, and coding with categorization. The data was carefully studied and reviewed repeatedly to understand the participants’ experiences. Meaningful phrases, statements, and words in relation to the issue of discussion were underlined, extracted, and sorted according to similarity before reaching a descriptive description. 

Methodology:

This was a qualitative study in which the authors employed a descriptive and exploratory research design. The researchers used a descriptive phenomenological approach to gather data through in-depth interviews, which is an appropriate method for such a study. To guide the participants through the interview, the researchers used open-ended questions and notes (Barkish et al., 2019). The researchers used a narrative approach to encourage a free speaking of the participants concerning their life experiences (Russell & Gregory, 2013). There was adequate time for each face-to-face interview session (60-120 minutes), and the environment was relaxed and comfortable for the participants (consulting room). 

A2.

The presented research problem is a weighty issue that cannot be fully exhausted by available research. Furthermore, the proposed research problem focuses on a matter of great relevance to nursing and healthcare practice at large, with a large sample space. There are noticeable gaps in the previous literature on the research problem, which calls for further studies to fill.  To obtain quality results, there is a need to employ a mixed methodology, which makes it necessary to conduct other research on the same research problem.

A3. 

The researchers met ethical considerations as they sought approval from the Ethics Committee of Kermanshah University of Medical Sciences (No 95126, KUMS.REC.1395.123). Informed consent forms were filled by the participants after the objectives as well as the procedure of the research were explained to them. The researchers identified themselves to the participants a made the purpose of the study and the possible benefits of the research evidence. The participants were made aware of their right to participate or to refuse to do so (Barkish et al., 2019). Finally, the participants were assured of privacy, confidentiality, and autonomy.

A4.  

The researchers adopted prudent self-control measures with strict discipline in their interactions with the participants besides being cautious in their interpersonal relationships throughout the study, which led to results agreeing with the previous studies. However, the selection of participants was localized to a single Kermanshah Counseling Center for Behavioral Diseases. As such, the findings might not give the real impression of the entire region. To further understand the results, there is a need for including a more extensive and more diverse sample size. 

A5.  

The general conclusion of this study is that the perception and the attention towards individual features of patients living with HIV are essential for nursing and healthcare providers as well as the counselors. This research’s findings acknowledge and highlight the importance of specialized care and nurses in general, prioritizing the needs of an individual’s needs and prevention of complications (Russell & Gregory, 2013). The quality of care has also been described in the article in accordance with the residents’ point of view to fulfill and optimize their medical psychosocial and physical needs while protecting their integrity.

PART B

Catalan, J., Tuffrey, V., Ridge, D., & Rosenfeld, D. (2017). What influences quality of life in older people living with HIV?. AIDS research and therapy, 14(1), 22. https://link.springer.com/article/10.1186/s12981-017-0148-9

This will be an evaluation of a quantitative research article by Catala et al., (2017), “What influences quality of life in older people living with HIV?.” This research article is equally of significant relevance to healthcare and nursing practice, as it studies the most world spread chronic condition. The article was published in the BMC part of the springer nature, which is among the most reputable journals that address issues that concern nurses at the global level.  

B1.

Background or Introduction:

Although the authors put the heading of the article as a question, the background and introduction are contiguous. The introduction has been used to contextualize the research problem with regards to the published study, stating the essence of the health-related quality for the elderly living with HIV and AIDS (Catala et al., 2017). The author is raising a concern on the increasing rate of acquisition of HIV at old age even though people who are living under the effective antiviral treatment continue to grow older and leave healthier lives nowadays as compared to the mid-1990s when those treatments were not yet available. The authors have also discussed the advances and changes in the treatment alternatives for the condition in question, concerning the HRQL. The authors have also discussed the impact of the disease upon the HRQL for older people living with HIV compared to younger people living with HIV.

Literature Review:

Past research and studies on factors influencing older individuals living with HIV have been adequately summarized by the researchers, which include symptom management, treatment, and self-care strategies. The researchers had acknowledged the explorations made by the existing literature on HRQL with regards to nursing, which aided their understanding of the concept before they embarked on the actual research. However, they have pointed out some gaps in the existing literature, including the failure to include control groups without HIV/AIDS in the studies (Catala et al., 2017). Therefore, the authors have seen the need to look into the physical effects of people living with HIV in relation to non-AIDS morbidity.

Data Analysis:

The researchers used an established statistical program called the SPSS to analyze the obtained data, which is an appropriate method for such kind of research. The authors describe having generated descriptive statistics for all the considered variables, but they have not given a detailed presentation of the statistics. Together with some analytic tests, multivariate analysis is mentioned to have been used for specific model developments (Catala et al., 2017). Even though the t-tests and multivariate analyses are acceptable reference techniques for determination of variation between variables, their interpretation, as well as appropriateness determination, depends on the specialist knowledge, which is not common among people, as it requires a significant level of statistical know-how.

Methodology:

The choice of the quantitative approach has not been clearly stated in the methodology section. This section has majorly concentrated on recruitment methods and the instruments used during data collection. Stating the quantitative research approach would have provided better standards of the evidence and greater rigor with generally better replication ability. Quantitative studies are believed to hold higher status compared to studies based on qualitative paradigms as far as healthcare research practices are concerned (Hoskins & Mariano, 2016). However, there have not been real discussion on the principles that underpin quantitative research. The detailed explanation of the research instrument helped in overcoming the limitation of asking the wrong questions to provoke answers regarding personal experience, which is common with quantitative research.

B2.

Even though the authors have used the introduction/ literature review to introduce and contextualize this study, they believe that the research problem would warrant a more critical and detailed analysis. Citing the previous studies as a means of credential establishment for another study is not enough. The study would have included a wide range of research to come up with better conclusions. Furthermore, the research ought to have been evaluated to establish its quality. The reader of this research article has been left the burden of pursuing this matter and determining the quality upon which the research bases its premise and justification (Hoskins & Mariano, 2016). As such, there is a need for further research on the same research problem statement.

B3.

There is no particular statement clearly indicating that the informed consent was achieved and that the researchers derived ethical approval from an appropriate body, both of which symbolize proper ethical consideration. As such, it is not clear that participants had the relevant information, miscommunication, or there was a misunderstanding between the researcher and the participants during the study. The authors have not explicitly addressed issues of confidentiality and anonymity, but instead seemed to concentrate on their own safety.

B4.

One of the strengths of this study could be considered to be the use of multiple data collection methods and instruments. The methods have been described in detail, and their provenance has been accounted for. The study has employed social support, symptom experience, self-care strategies, and HRQL questionnaires (Catala et al., 2017). The research addressed the demographics of the sample to some extent. Multiple data collection methods and instruments also helped in addressing potential confounding factors or variables. However, the study does not indicate how and who administered the questionnaires. It does not indicate the time limit for which the participants were to submit the questionnaires, or whether the participants were aided into responding to the questionnaires. As such, the result obtained is vulnerable to bias or compromise, which may lead to questioning of their validity and reliability. This, combined with the failure to observe ethical considerations, may be regarded as the major weakness of this research.

A5.

Apparently, the study shows a severe impact that social factors exert upon the lived experience as well as the target population’s HRQL. The study has also made it evident that medical aspects may also be overweighed by the social factors except for antiretroviral therapy provision. It would, therefore, appear that understanding the relationship between these factors could help improve healthcare and nursing practices for older people living with HIV/AIDS (Hoskins & Mariano, 2016). As such, this article does not only bear significant relevance to healthcare and nursing practices but also forms a resourceful document for further researches on the same problem statement.

References

Barkish, F. G., Jalali, R., & Jalali, A. (2019). Experiences of patients with primary HIV diagnosis in Kermanshah-Iran regarding the nature of HIV/AIDS: A qualitative study. Heliyon, 5(8), e02278. https://www.sciencedirect.com/science/article/pii/S2405844019359389

Catalan, J., Tuffrey, V., Ridge, D., & Rosenfeld, D. (2017). What influences quality of life in older people living with HIV?. AIDS research and therapy, 14(1), 22. https://link.springer.com/article/10.1186/s12981-017-0148-9

Hoskins, C. N., & Mariano, C. (2016). Research in nursing and health: Understanding and using quantitative and qualitative methods (Vol. 23). Springer publishing company.Russell, C. K., & Gregory, D. M. (2013). Evaluation of qualitative research studies. Evidence-Based Nursing, 6(2), 36-40. https://ebn.bmj.com/content/ebnurs/6/2/36.full.pdf