加拿大护理学essay:探索儿童的信息需求_加拿大essay_ESSAY

加拿大护理学essay:探索儿童的信息需求

循证护理，因为我们都知道，包括研究发现的证据。这不仅有助于临床决策，还要考虑患者的喜好和的的确确的帮助并提供最好的照顾（Royle & Blythe，1998）。要使用最有效的证据，严格评价是必不可少的。 Polit & Hungler（1997）表明严格评价有助于在护理知识的进步中发挥重要的作用。跟据Burns & Grove（1997），严格评估扩大了了解，并改善了护士的行为习惯。这篇文章，是读者去批判的，是“儿童的术前信息的客户需求”。在文中，批判的人会被称为读者和文章的作者，正在被批判的被称为研究者。

本研究的目的是探索儿童年龄在7-11岁的有关计划入院手术的信息需求”。目的着重于探索和确定一组儿童的知识，这表明的现象却知之甚少（Talbot，1995）。据读者了解，这是一项探索性研究，探索性研究不使用假设。研究人员称没有假说。研究人员表示，很少有已知的现象，因为没有关于这方面问题太多的信息。因此，在这种情况下，假设不会被论证（Burns & Grove, 1997）。定性设计没有测试任何理论因此；它并没有解决假设（Talbot，1995）。

这项研究包括了广泛的问题，在择期手术入场前，儿童是否可以确定自己的信息需求。问题是被明确定义的，因为它有一个学习小组和关键概念。这个广泛的问题可以产生广泛的答案，这确实有助于研究者深入探讨。根据Polit等人（2001），研究的问题更加集中在收集和分析数据。

Explore the information needs of children

Evidenced based nursing, as we all know includes evidence available from research. This not only helps in making clinical decisions, but also considers patients preferences and indeed helps to provide best possible care (Royle & Blythe, 1998). To use best available evidence from research, critical appraisal is essential. Polit & Hungler (1997) have denoted that critical appraisal of research helps to play an important role in the advancement of nursing knowledge. According to Burns & Grove (1997), critical appraisal broadens the understanding and improves practice of a nurse. The article, which the reader is going to critique, is “Children's accounts of their pre-operative information needs”. Throughout the essay, the person who is doing the critique will be called as reader and the author of the article, which is being critiqued, will be called as researcher.

The purpose of the research was to “Explore the information needs of children aged 7-11 years relating to planned admission for surgery”. The purpose mainly emphasizes on exploring and identifying the knowledge of a group of children, this indicates that very little is known about the phenomena (Talbot, 1995). According to the readers, understanding this is an exploratory study and exploratory study do not use hypothesis. There is no hypothesis stated by the researcher. Researcher denotes that very little has been known about the phenomena and as there is no much information available regarding this subject. Hence, in this case hypothesis will not be formulated (Burns & Grove, 1997). Qualitative design does not test any theory therefore; it does not address hypothesis (Talbot, 1995).

This research includes broad question, which is whether children could identify their own information needs prior to admission for elective surgery. Question is being clearly defined because it has a study group and key concept. This broad question could generate a broad answer and that will indeed help the researcher to explore in depth. According to Polit et al (2001), the research question becomes more focused as the researcher collects and analyse data.

Reader strongly argues that this research is worthwhile because children have their own right to know regarding their treatment and it is important to consider their views seriously while planning services and making decisions (Department of health, 2003). This research will contribute developing a proper tool to render information needs to children in an appropriate way.

Very limited research has been done related to this topic. Moreover, not all these research studies included children directly instead they have talked about parents and health care professional's views rather than direct report from children. The researcher has discussed about other related topics while planning this research. During this process, the researcher has managed to think critically on the related topics and has pulled out the conflicts, inconsistencies, strengths and weakness in the review of literature. The researcher has used most available literature while planning this research. Summary of the review on literature leads the reader to acknowledge the importance of this research project. The review of literature follows the purpose of the study (LoBiondo-Wood & Haber, 2002).

The literature review of this particular research project is up-to-date and comprehensive. The researcher has included all possible literature available related to this study. This research was given for publishing in year 2004 and was published within a year i.e. in year 2005. Hence, it is up-to-date. The researcher has referenced the literature accurately by using Harvard reference system (Cormack, 1996). Moreover, it is easily available from the libraries.

This research deals with the children, their feelings, fear and concerns. Reader believes that qualitative research design is the most appropriate to this particular research. Burns & Grove (1997) argues that qualitative research seems to be a more effective method of investigating emotional responses, since human emotions are difficult to quantify. According to readers understanding in order to find out children's ability to identify their pre-operative information needs, this design should include methods like interviewing or communication, which is a part of qualitative research method (Talbot, 1995). Even through review of literature, it was significant that very little is known about this phenomenon. Therefore, it is ideal to choose qualitative design to examine this subject in depth (Polit & Hungler, 1997).

Other research design will not be suitable for the study of this phenomenon. Here the researcher is not aiming to examine the relationship between variables, furthermore numerical data will not help to explore the children's account of their pre-operative information needs (Burns & Grove, 1997).This research includes children of age 7-11 years. The reader argues that children of this age cannot be pressurised to take part in formal interviews, as they will not come out with their ideas in pressurised setup. Where as in a non-threatening environment they feel free to express their views and tend to be more friendly (Cormack, 1996).

Researcher has obtained Ethical approval from the Liverpool children's ethics committee. Ethical issues involved in this research have been addressed adequately. The researcher has obtained consent from parents and verbal assent from the child prior to collecting the data. Allmark (2002) has discussed about how parents consent functions to protect child's welfare. Children belong to vulnerable group and they do not have the competency to give their informed consent (The royal college of nursing research society, 2003). Researcher has given opportunity for both parents and child to refuse from participating in the research (LoBiondo-Wood & Haber, 2002). There is difficulty in maintaining confidentiality when small group is selected for research. Burns & Grove (2003) and Polit & Hungler (1997) have discussed about difficulties in maintaining the anonymity of the participant. Even though the researcher held the participants as anonymous and data was collected at home 1-2 weeks prior to the child's admission. Reader strongly feels that in this case anonymity is impossible to maintain. When the data was collected at home, there is a greater invasion of privacy moreover; presence of parents may influence the information given by the child (Polit & Hungler, 1997).

Data was collected by using write and draw technique with informal interview. Cormack (1996) has suggested that collecting data within natural situation allows the child to feel comfortable and child tend to open up in unthreatening environment. Therefore, the data collected will be most significant. In the research where the aim was to explore the information needs of children this informal interviewing technique was used appropriately. Informal conversations are more likely to lead to friendly and natural discussion (Ireland & Holloway, 1996). During interview, the researcher used tape recorder at the same time. This permits the researcher to observe all the clues, pattern or modulation of speech, which the researcher might have missed, and help to review and understand properly during data analysis (Talbot, 1995). Researcher allowed the child to control the recording. According to Mahon et al (1996), this increases the willingness and rapport and helps the child to be more open while answering question.

The draw and write technique used is appropriate for the children of this age group. Children find it difficult to express their feelings for a stranger verbally. Write and draw technique method offers insight into a child's experience and helps for discussion in depth (Hart & Tyrer, 2006). Reader thinks that it is difficult to conclude what the child has drawn unless and until you ask the child to explain. Backett-Milburn and Mckie (1999) have argued that draw and write technique fails to reflect the process involved in the construction and collection of data. Punch (2002) also suggests asking the child to explain what their drawing meant to them in order to analyse the data. By asking broad question, researcher has facilitated the child to come out with questions and their need to know about pre operative information needs. This has helped the researcher to collect enough information related to the research.#p#分页标题#e#

As seen in the research topic it has been noticed that researcher has not discussed the efforts made to enhance the trustworthiness of the data. Though the researcher has stated that this method of collecting data is relevant to this particular age group of children, it is not been clearly explained, according to the criteria to be followed to evaluate the credibility, dependability, transferability and conformability of the data (Lincoln and Guba 1985, cited by Polit et al 2001). For the implication of the research findings in practice, obtaining validity and reliability of the method is very essential (Holloway & Wheeler, 2002).

The researcher has selected a sample of nine children of age 7-11 years, who have never been admitted to the researcher's work place. The sample was chosen on purposive criteria. The children were recruited from the proposed theatre list of surgeon of various specialists, including day case and prolonged stay patients. There was considerable self-selection from the 40 families invited to participate. Researcher has selected participants according to the need of the study (Morse 1991, cited by Coyne 1997). Burns and Grove (1997) also suggest choosing the sample from selected population that meets the criteria.

In this qualitative research, reader agrees that small sample will provide accurate information. The researcher will be able to focus in depth and can yield accurate and meaningful findings (Patton 1990, cited by Coyne 1997). When there is large amount of verbal data must be analysed which is also more intensive and time-consuming, small sample is convenient (Sandelowski 1986, cited by LoBiondo-Wood and Haber 2002). According to Talbot (1995) small sample gives rise to bias while generalizing the results on chosen population. The small sample is handpicked and hence it has limited ability to generalize. It is difficult to say whether the rest of the population will also give the same data. In addition, if this method is applied for other population with same age group of different culture and who already have experienced hospital stay, may give different information.

The data gathered from the interview and write and draw technique was analysed by using five distinct phases. They are familiarization, identifying a thematic framework, Indexing, Charting, Mapping, and interpretation. Researcher has explained the analysis process superficially. Data analyses lead to development of three themes. These themes explain in detail what the children knew about their admissions, how they got information and what they wanted to know. These themes are appropriate to the purpose of the research.

The conclusion of this study focuses on children's ability to outline their current knowledge and questions about their forthcoming admission. Researcher concludes the research by saying that children of 7-11 years can identify their own information needs. Moreover, some children had very little information about their forthcoming surgery and none of them had received information directly from health professionals or children's hospital, which they were to be admitted. The results drawn from this research work drives the reader to agree that it has answered the original question. Few recommendations have been made by the researcher for further research to explore the information needs of children from different cultural background and to test the most appropriate method of delivering information to children. These recommendations are worthwhile to act upon because there are children with wider age range and different cultural background undergo surgery everyday. It is not practical to believe that they get accurate information from their parents or other sources. Reader comes across many children starting from the age of 3-16 years who attend preadmission clinic everyday. In addition, it is worth giving information to children according to their age and level of understanding (Rushforth, 1999). In this research, the researcher has spoken about children from 7-11 years of age. Then what about the rest of the children? Reader feels that running the preadmissions clinics will be useful only if they give proper information to children according to their age and according to their level of understanding.

This research has its own strengths and limitations. In the beginning, reader struggles to understand the aims and objectives because according to the research methodology the aims and objectives should be explained at the beginning, whereas in this research it has been explained in later pages. The researcher has done a good review of literature and theoretical underpinning. However, when the research is been carried out the method used to gather information from children has some inadequacy. It is not sure weather the results can be generalized on the whole population. Data analysis is not been explained clearly. Results drawn from this research is easy to follow and recommendations made for further study is worth considering.