Generating broad subject so there were hundreds of articles

Generating a focus of enquiry.

This
assignment will be a report which relates to a literature search, that is based
on the topic respect and dignity. I will demonstrate step by step how I went
from a huge number of articles to then pick out 2 articles which I felt were
the most appropriate to me. As the topic of respect and dignity is very broad I
decided to narrow my search down to respect and dignity in end of life care. I
believe this topic will help me throughout my nurse training, my nursing career
and help with my clinical placements. All nurses and midwives must follow the
NMC Code, the code sets out standards. One of the standards within the NMC Code
is ‘treat people as individuals and uphold their dignity.’ (NMC 2010).

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To
help me gather an appropriate research topic I used the acronym FINER which I
learnt about in university. There are 5 parts to the FINER framework feasible,
interesting, novel, ethical and relevant. This framework allowed me to decide
whether my question is feasible and interesting. It also helped me to decide
what gap my question will fill within the existing literature, this framework
also helped me to ensure my question was ethical and relevant.

Research
is important to the nursing profession and other medical professions as it
provides new insights into nursing practice, which helps to develop and improve
the way in which we care for our service users and help to test the
effectiveness of care. There have been several changes that have happened
overtime such as the improvement in medical technology which has led to more
positive outcomes in health and as this has happened the public also introduced
their expectations of healthcare services. (Gerrish and Lacey, 2010). I will be
searching for articles which relate to respect and dignity in end of life care,
by reading articles I will gain a better understanding and more knowledge on
this specific subject.

 

Retrieve the correct type of information

To
start my literature search I began with the key words “respect and
dignity”. This is an extremely broad subject so there were hundreds of
articles available so then I decided to add in other key words which were
“end of life care.”  I used
Boolean operators for this search by using the word “and” I used this
word because I needed both words “respect” and “dignity” to
fit with my topic. Using the word “and” meant the databases I used found
articles containing both words. “Boolean “AND”/ Boolean
“NOT” are used for narrowing a search. The Boolean operator
“and” is the most common way to narrow a search to a manageable
number of hits.” (Sharma, 2008). The first database I used was Google Scholar,
I used my key words “respect and dignity in end of life care” and the
articles which came up weren’t appropriate for me, some of the articles were
dated so I filtered my search to show me articles between 2012 and 2017 as I
wanted to find a research article no more than 5 years old. Although I filtered
my search down more the articles still weren’t appropriate a lot of them were
based American and China, because of this I decided not to use Google Scholar
as it wasn’t the best database for me to use within my report. I then decided
to use a database from the University of Wolverhampton website, so I went onto
the university website and type in nursing databases which then gave me around
12 different databases I could use. I decided I was going to try two of them
CINHAL and MedLine, I thought I would try out these databases as I knew these
were the most popular as these had been recommended by lecturers and other
student nurses.

The
first one I chose to use was CINHAL as this database seemed simple to use. I
used my key words “respect and dignity in end of life care” this
brought up over 3,500 articles from the year 1957 to 2017 I knew I needed to
narrow down my search some more to get the most relevant articles. I narrowed
my search down by using the refine tool on CINHAL I refined my search by
changing the publication date to between 2012 to 2017 as I needed to find
articles within the last five years. By changing the publication date, I
narrowed the articles down to 1,400. I then narrowed down by ensuring all
articles had the full text available which made it come down to 562 articles, I
then narrowed down to ensure the articles had references available which
narrowed my results down to 124. By doing this I was successfully narrowing
down my searches to ensure I have relevant articles for my report. After this I
changed the journal subset to UK & Ireland which gave me 76 articles. After
skimming through the links to articles that had come up out of 76 there were
only 2 that were relevant to my subject area. One of these articles I found
would be good to use as it was a quantitative article based on assessing the
quality of care delivery at the end of life and showed results of where
professionals showed service users respect and dignity when they were at the
end of their life. This article had a good amount of relevant references too.

I
was struggling to find a good qualitative article through CINHAL, so I thought
I would try another one of the University of Wolverhampton databases which was
MEDLINE. I chose this database as I knew this was another popular database and
it was fairly similar to CINHAL. So, I typed in the search bar respect and
dignity in end of life care which brought up over 4,000 articles. I narrowed it
down by changing the year of publication to the last five years and made sure
the full text was available.  Narrowing
my search down like this made my searches come down from 4,000 to 400. I added
another keyword to my search which as importance when I added this word I got
my articles down to 87 and then I skimmed through the articles that had come up
and found one which would fit well as a qualitative piece. The other articles
seemed to be very short and didn’t have the relevant information I was looking
for as a couple of the articles were based around cancer, another was based in
an Italian hospital. The one I chose was based around “a
pilot study using the patient dignity question as an intervention to enhance
dignity and person-centred care for people with palliative care needs in the acute
hospital setting.” This
article contained good references too.

 

Appraise the information

After
reading both of my research articles, I looked into the background of the
researchers. One of my articles is quantitative and the researcher is John
Tingle, my other article is mixed method and the researcher for this article
was Bridget Johnston. Firstly, I will be discussing John Tingle his background,
roles and if the work he did matches the work that he undertook. After this, I
will be discussing Bridget Johnston and her roles, backgrounds and whether the
work she did matches the work she undertook.

John
Tingle’s is a Reader in Health Law and is the Director of the Centre for Health
Law.  Tingle’s current research is
looking at the legal aspects of the government’s health quality policy
initiatives, including clinical risk management and clinical governance. Tingle
carries out research around clinical negligence claims and complaints against
the NHS, he identifies the agencies which have been created to help manage
litigation and risk and have been created to improve the quality of care for
service users.  Another one of Tingle’s
research interests is the legal aspects of nursing, his interest focuses on the
extended role of the nurse. Tingle regularly writes on patient safety for the
British Journal of Nursing.

The
work which John Tingle undertook matches with his backgrounds, roles and
interests. As Tingle carries out lots of research around health and nursing for
example clinical negligence claims and complaints. The article which I have
chosen to use is based on assessing the quality of care delivery at the end of
life. By carrying out this research Tingle may have come across some complaints
and may also have come across cases of clinical negligence, so this article
does match. Tingle also writes about patient safety for the British Journal of
Nursing which is another reason why the research he undertook links with his
backgrounds and roles.

Tingle
talks about the key findings from the “First National VOICES Survey for
bereaved people” within his article. This survey is how John Tingle
collected his quantitative data. The survey was designed to create a comparison
between people who were dying at different ages. The survey was designed to
have people less than 65, 65-79 years old, 80 years old or more, those with
different causes of death such as cancer and for people who were receiving care
from many different healthcare settings within the last 3 months of life. This
includes hospitals, home, hospices or care home. I believe a big sample size
was chosen so that the findings came from a wide range of sources, so that
Tingle had a lot of information to feedback which made the survey more
effective.

The
way data was collected in Tingle’s article was consistent with the type of
research that was being carried out as the data was being collected through
people who were at the end of their life and their families. The survey was the
same for every person who gave their feedback. A restriction for Tingle’s
research could’ve been time as the survey included a lot of people from all age
groups in many different settings so a lot of time was needed to carry out this
research.

The
researcher who undertook the research for my mixed method article is Professor
Bridget Johnston. “Johnston is the Florence
Nightingale Foundation Chair in Clinical Nursing Practice Research in Nursing
and Health Care.” (University of Glasgow, 2016). Johnston’s background consists
of educational, clinical and research in palliative care. Johnston has
undertaken post-doctoral research and included in this research is palliative
care symptom management in palliative care and testing interventions relating
to dignity and end of life care. Johnston was Chair of the Palliative Care
Research Society from 2008-2011. She is also a Consultant Editor of the International
Journal of Palliative Nursing. Johnston’s research interests included end of
life or palliative research in nursing, dignity and end of life care, and
palliative care issues in the care of an older person.

Johnston carried out mixed method type of research by doing a
pilot study. I believe that Johnston chose to do this type of research so that
she could gain lots of information from a range of different sources to ensure
her research is effective. To gain quantitative information Johnston decided to
use the PDQ (Partnership Defined Quality) patient and family feedback
questionnaire, the PDQ healthcare feedback questionnaire was used also to
provide an outcome to participant views about dignity. Qualitative data for
this study was collected by semi-structured interviews and open responses from
the feedback questionnaires.

Johnston considered previous work done in her area of interest
as she has carried out a similar study to the one I have chosen in another
setting. I have chosen a study in a hospital setting, she also has another
study which is based in the community setting. This allows the researcher to
spot differences throughout different settings and helps to strength the
research they are carrying out by having multiple studies look back on when
carrying out new research. 

The way Johnston collected data was consistent with the type of
aim she had as she undertook interviews with people who could relate to the
research she was undertaking. A restriction for Johnston’s research was time
and that the research could’ve been done over a wider geographical area and
more settings would’ve been beneficial.

 

Do it – Applying the theory to practice

Both articles I have chosen have an impact of nursing practice
as they both highlight the respect and dignity given to service users who
received care at the end of their life. The findings highlight some concerns
the service users themselves and their family had towards the respect and
dignity that was shown. The concerns which were highlighted could be looked
into and then minimised so that the respect and dignity shown and given to
service users at the end of like could be improved.

Both articles I have chosen I believe agree with a number of the
NICE guidelines. Both articles especially related to a quality statement from
the NICE guidelines focusing on end of life care for adults. “People approaching the end of life
and their families and carers are communicated with, and offered information,
in an accessible and sensitive way in response to their needs and
preferences.” (NICE, 2011). I believe that Tingle’s article agrees with
this statement because in a section of Tingle’s article the heading is
“Decision making, choice and communication” this part of the article
discusses how service users who were at the end of their life and their
families felt they were being involved in the care that was being provided, it
also discusses how sensitively service users and their families were spoken to
when they were told they were going to die. Tingle’s article agrees with this
statement set out by NICE as he assessed how sensitively people were spoken to
when it came to talking about their health, which is what the NICE statement
set out for professionals to follow.

Johnston’s article also agrees with this NICE statement as in a
section of her article where she discusses her findings she talks about how
service users and staff communicate with each other. She talks about how it can
be harder for staff in an acute setting to speak to individuals about sensitive
subjects privately due to the setting they’re in. I believe this article agrees
with this statement because Johnston spoke about how service users are spoken
to about sensitive subjects and it states that service users should be
communicated with and offered information in a sensitive way.

 

Evaluate – Reflect on what I have learnt

Within my personal development plan, I stated that I had never
used a database before and this was a weakness for me in carrying out my
assignment. Now that I have done my assignment I find using a database easy and
I know how to effectively narrow down my searches to bring up articles that are
most relevant to what I’m finding out. Three elements of my learning which I
knew needed developing, that I could make use of if I did develop were learning
using a database, reading critically and learning the difference between a
database and a search engine. To reflect on what I have learnt I have used the
Jennifer Moon’s reflection on learning.

I noticed that I needed to learn how to use a database, I went
on several different databases that I could use for my assignment before I
started to learn how to use one and learn how to narrow searches down.  I also needed to develop my critical reading
skills and to help me with this I looked back at my lecture notes to prompt me.
I also needed to learn the difference between a database and a search engine so
that when I was trying to find my articles I was looking in the right place.

I made sense of what I had learnt by reading around what I
didn’t understand and using different databases before I did my assignment. I
also made sense of what I had learnt by reading my articles and identifying how
my two authors had carried out their work differently.

I made meaning from what I had learnt by carrying out the work
required for my assignment and reading around areas which I felt I needed to
develop. This meant that I felt more confident in doing my assignment because I
made meaning of things which I didn’t understand.