Kangaroo Care Review

A critical analysis of the article, “The Effect of Skin-to-Skin Contact (Kangaroo Care) Shortly After Birth on the Neurobehavioral Responses of the Term Newborn: A Randomized, Controlled Trial”. By Sari Goldstein Ferber and Imad R. Makhoul shows that it is a quantitative study. The authors aimed at evaluating the effect of Kangaroo care in terms of delivery upon the behavioral responses of the healthy newborns. Thus, the quantitative study dwelt on the skin to skin contact has shown in the physiological, cognitive, and emotional gain for preterm infant. Therefore, the title and abstract of the study clearly espouses the objectives of the research, as well as an outline of the study design, subjects, results, and the conclusions.

The research title is the first instance the audience meets with the research concept, and therefore, the title should articulate the research topic in a manner that draws the readers’ interest to the topic. This implies that the topic should reflect on the objectives and final goals of the research study. The knowledge and expertise of the researchers is authenticated and they are experts in their medical and academic professions, therefore, they are capable to handle the scope of the research study. Therefore, the systematic review of the research article require appraisal, summarization, and integrating the information into a single idea or notion that will help the targeted audience the variable quality and scope of the important aspects of the research. Starting with the abstract, it is apparent that the research study has touched on the pertinent issues concerning the entire research. The author has provided a brief summary of research problem or questions with the corresponding hypotheses, and it is apparent that the abstract includes the problem statement, as well as the method used and the findings, a brief discussion of the results is also provided and the overall conclusions and recommendations of the research study.

The research study in question provides sufficient literature review.  The researcher has adequately provided background information concerning the requirements and the needs of a comprehensive literature review. The literature review elaborates more on the topic under study, as well as the appropriate methodologies of conducting the quantitative research. The authors elaborate the research methodology used in collecting and analyzing the data, and therefore the study design chosen is appropriate in answering the research questions. The researchers used the randomized controlled trails in collecting the data of the neurobehavioral responses of the healthy newborns. After gaining consent from the research participants, the researchers assigned mothers to 1 or 2 groups categorized as Kangaroo care after short delivery and no-treatment standard care, which was the control group. Kangaroo C are infants were brought to the nursery 15 to 20 and 75 to 80 minutes after birth, and 15 to 20 minutes after delivery that lasted for an hour. Therefore, the study design was valid and reliable, as well as posses the characteristic of replicatability.  

Therefore, factors such as the sample size, target population, data collection tools, data analysis technique, and Program Evaluation and Quality Improvement designs are used well by the researchers, in the case that they are well exemplified. Looking at the presentation of results and findings, the authors have used both qualitative and quantitative methods to represent the data. The researchers have used tables, graphs and chart to illustrate their findings from the collected data, as well as inferential statistical methods in data analysis. For instance, they have applied analysis of variance in testing the research hypotheses, which augments the validity and reliability of the collected data, as well as the results. The advanced statistical methods in the data analysis add credibility to the research results. The researcher may choose to present the data inform of graphs and charts in order to enhance the presentability of the findings to the audience in a more appealing manner. The author of the research study has methodologically presented the challenges, as well as the possible solutions within the context of addressing the research questions. The critique of the quantitative research study should focus on the benefits and limitations the researcher displayed in the relationships between the research design, finding, results and the discussions. Thus, the quantitative research study should discuss the hypotheses in details, as well as the author being able to provide new information regarding the topic under study.

The researcher further notes that experimental research designs tend to have more risks, as compared to other kinds of research methods, and therefore considering ethical issues helps in addressing matters that may arise in the participants’ decision to cooperate with the researchers. The critique of the quantitative research study should focus on the benefits and limitations the researcher displayed in the discussions from the research results. Thus, the quantitative research study should discuss the hypotheses in details, as well as the author being able to provide new information regarding the topic under study. Thus, the author argues that the discussion section should emphasize overall statement about the results in relation to the information derived from the experimental design.

The researchers concluded that Kangaroo care appeared to impact the state organization together with the motor system modulation of the new born infants shortly after delivery. Therefore, the conclusion wraps and consolidates everything into one or more points of view about the topic under research. The researcher reviewer should focus on the in the results in drawing valid conclusions about the position or positions taken concerning the thesis statement.  It is apparent that the conclusions have answered the research questions, and therefore the authors have achieved their objective of the research study. Hence, the researchers have contributed positively in influencing future research direction to the topic under study. It is also prudent to provide a brief discussion about the implications of the research on nursing practice, and as well as the future direction of research in the field of study. Finally, the author insists that the conclusion or summary should pull all the information together, as well as the lessons leant. Therefore, medical and nurses may well use the information and advice in a prudent manner in order to provide this kind of care shortly after birth to the newborns in controlling the skin to skin contact neurobehavioral responses.

Reading a Research Study

Reading a research article provides the audience with in depth information concerning the topic understanding. Therefore, the authors of research articles are required to present their information in a concise format, as well as information should flow from one idea to the other. The research title is the first instance the audience meets with the research concept, and therefore, the title should articulate the research topic in a manner that draws the readers’ interest to the topic. This implies that the topic should reflect on the objectives and final goals of the research study.

A quantitative research review paper should therefore, consist of the reviewers’ objective criticisms of the research title, abstract, knowledge and expertise of the researchers, the research method and design, as well as other aspects of the research such as the reliability of the research questions in relation to the research methodology.   The research article in question is about “Reading a Research Study: An Instructional Guide” by Arlene J. Lowenstein. Therefore, the systematic review of the research article require appraisal, summarization, and integrating the information into a single idea or notion that will help the targeted audience the variable quality and scope of the important aspects of the research. Starting with the abstract, it is apparent that the research study has touched on the pertinent issues concerning the entire research. The author has provided a brief summary of research problem or questions with the corresponding hypotheses, and it is apparent that the abstract includes the problem statement, as well as the method used and the findings, a brief discussion of the results is also provided and the overall conclusions and recommendations of the research study.

Hundreds of research studies on nursing interventions are published frequently, and most people involved in providing nursing care to identify and consider these studies in their decision making. To this end, the research study in question provides sufficient literature review.  The researcher has adequately provided background information concerning the requirements and the needs of a comprehensive literature review. The literature review elaborates more on the topic under study, and therefore, the researcher provides more information and insights of how to select publications in terms of period and scope, as well as how to critically compare among research articles. The researcher is also keen on the in-text citations, and how they are used in providing evidence based review of literature in terms of theory, principles, and new research designs specific to the literature review. In-text citations are important for authenticating the sources of literature publications used in the research study, and therefore the selected research articles should help in answering the research questions.

The research methodology is a critical stage in research development, and therefore nurses should be keen on the research designs that are appropriate to then objectives of the study.  The distinction between qualitative and quantitative research designs is paramount before embarking on a research study. Therefore, factors such as the sample size, target population, data collection tools, data analysis technique, and Program Evaluation and Quality Improvement designs. Nurses’ should use appropriate methods in identifying and appraising both published and unpublished literature using systematic reviews of peer journals, so as to be able to describe the quality of evidence based research study reviews.

Nursing practice requires professional ethics to be adhered to in conducting research studies, and therefore, the author emphasis the need for ethical considerations.  The author espouses the ethical issues in an astounding manner by elaborating the ethical issues in both qualitative and quantitative research designs. The researcher notes that the study design should be approved by a review board in order to ascertain that all ethical dilemmas are dealt with in an appropriate manner.  The researcher further notes that experimental research designs tend to have more risks, as compared to other kinds of research methods, and therefore considering ethical issues helps in addressing matters that may arise in the participants’ decision to cooperate with the researcher.

The research findings come as a very significant component of the research design. Here, the researcher consolidates the collected data into meaningful formats. The researcher may choose to present the data inform of graphs and charts in order to enhance the presentability of the findings to the audience in a more appealing manner. The author of the research study has methodologically presented the challenges, as well as the possible solutions within the context of addressing the research questions.

This section depends on the study design, and describes the data in relation to the demographic factors, such as age, education, gender, for qualitative studies. In the case of quantitative research studies, the results and findings section provides the data analysis methods, which can also apply both descriptive and inferential statistics. The author has clearly described the nature of data analysis, and vividly articulates the sources, study selection, quality assessment, and the extent to which the search for the reviews was undertaken. The results further, illustrate description of the inclusion criteria, assessment of bias in the publications, as well as the implications of the research study for practice and research.

The critique of the quantitative research study should focus on the benefits and limitations the researcher displayed in the publications. Such critique should include the overall presentability, and a clear linkage should be seen in the various stages of the research. However, discussion from the results and findings should be highly correlated to the research questions. Thus, the quantitative research study should discuss the hypotheses in details, as well as the author being able to provide new information regarding the topic under study. Thus, the author argues that the discussion section should emphasize overall statement about the results in relation to the information found in the published literature.

The conclusion wraps and consolidates everything into one or more points of view about the topic under research. The researcher reviewer should focus on the in the results in drawing valid conclusions about the position or positions taken concerning the thesis statement.  The author should be able to provide a clear answer to the research questions, and comment whether the research objectives have been achieved. It is also prudent to provide a brief discussion about the implications of the research on nursing practice, and as well as the future direction of research in the field of study. Finally, the author insists that the conclusion or summary should pull all the information together, as well as the lessons leant.

 

Self Care Deficit Nursing Theory

 

Ensuring a healthy life style is a central focal point for every individual, community and the government. With every individual of the society being healthy, the community as a whole will be healthy. Consequently the government will have to spend less on health sector and will have more chances of diversifying its public sector spending. When we talk about ensuring a healthy life style, self care is the most important element. In fact, self care is the basic pillar on which all other elements stand.

According to Orem, self care comprises of all activities than an individual initiates himself in order to ensure his health and well being (Nursing Theories 2010).  These initiatives may include taking care of minor things which individuals normally tend to overlook. This may range from taking physical care by ensuring sufficient intake of food, water and air to taking care of mental health by creating a balance between rest time and activity.

However, when an individual fails to take care of his well being on his own behalf and needs a medical assistance, it is referred to as self care deficit. It is this self care deficit which paved way for various nursing theories and highlights the importance of the role that nurses play in a society. Orem (Alligood and Tomey 2006, p. 255) states that nursing is a helping service and its goal is to overcome human limitations and to make certain that the patient is provided with assistance to cope up with his illness or injury until he rovers from it. When an individual is unable to cope up with his physical or mental instability, nursing renders him the required assistance and the methods and techniques that nurses use in order to attain their goal is known as nursing system.

 

Self Care Deficit Nursing Theory:

Summing up the individual concepts of self care, self care deficit and nursing, leads us to the Self Care Deficit Nursing Theory. According to Parker (1993, p. 241), Self Care Deficit Nursing Theory is a nursing theory which aims at providing direction for practice to nurses. Since the primary aim of nurses is to provide assistance to their dependant, they need a direction to help patients meet their self care need. This means nurses need to understand the proper nursing system and apply it in their practice.

About a century back, nursing was considered as a low profile, vocational occupation. However, with the theory based nursing studies and a proper nursing system in place, it has become a more meaningful and professional occupation. Florence Nightingale was the first person to highlight the need of a nursing system. Since then the profession has evolved through various phases. In the contemporary era, Dorothea Orem came up with a comprehensive approach towards how the profession should be practiced so as to achieve the required results. Today, nursing is studied like any other dignified science discipline.

Starting with initial nursing theories, according to Cherry and Jacob (n.d., p. 56) , Nightingale’s concept of nursing and care taking was the most comprehensive one of that era. It revolved around elements including ventilation, noise, variety, diet, light, happiness and hygiene. This meant that she recognized and took an initiative to create awareness about the fact that health care has a scope much beyond the conventional definition of health care.

Various nursing theorist came up since Nightingale’s era and although the basic idea of all theorists was more or less same, however, with the passage of time nursing theories have taken a more scientific approach. While Nightingale’s theory was only based on physiological and psychological human needs, contemporary theorists have added spiritual, moral and social dimensions to it too. For instance, Henderson’s nursing theory covers all elements proposed by Nightingale, along with elements like spiritual worship, maintaining body postures and temperatures, freedom of expression, elimination of body waste, avoiding environmental dangers and ability to learn in order to satisfy human curiosity. Having said that, Henderson’s theory assumes that the patient would be willing to return to health and nurses are will have to look after him only until he recovers. Another assumption is also made that all nurses will perform their task with unconditional devotion. Both these assumptions are not always true.

Moving on to the contemporary era, Orem’s nursing theory is not only more comprehensive, but also more scientific. According to Orem, Self Care Deficit occurs when the self care agency fails to meet the respective self care demands. This shortfall results in self care deficit and thus indicates that a nursing agency is required. Her theory starts with the preventive element of self care, highlights the role of nurses after self care deficit occurs and extends that role not to just the recovery of the patient, but also to educate the patient about self care. This approach makes Orem’s approach more sustainable as it does not restrict itself to health care provision, instead it also focuses on health promotion and maintenance.  The biggest limitation of her theory is that it focuses primarily on illness rather than well being as a whole.

There are various other nursing theorists that emerged since then. Each of them added new dimensions to nursing theories including behavioral systems, environmental energies and interpersonal processes. As a consequence the science of nursing has evolved over a period of time, thus providing basis for further research and expanding the scope for development of nursing as an academic discipline.

Application of Nursing Theories:

Nursing theories are beneficial in a way that they define relationships between various elements associated with the field of nursing and health care. These theories further provide a direction for its research and practical application and helps predicting the consequences of that practice and the response of the dependant. The study of nursing theories helps nurses to understand and explain their experiences. Most importantly, it helps them to be able to critically analyze a problem or a situation that they would not be able to do otherwise. As a result their ability to find alternate solutions to their problem enhances. Moreover, it helps them in effective decision making and ensuring the quality of nursing care.

In research and education, the study of nursing theories helps in generation of new ideas and assists in discovering and filling the information gaps in particular areas of study. It further helps in designing the curriculum for the study of nursing as an academic discipline. Many of these nursing theories emphasize the idea of observation and states that any event that is experienced by the dependant, or the nurse, or by both during their interaction should be considered as part of the nursing practice. This concept not only makes way for more communication between a patient and a nurse, but also helps understanding and predicting events that could not have been understood and predicted otherwise. The application of various nursing theories in practice helps the dependant to achieve greater level of satisfaction.

Community Assessment:

The term community in general means a group of people who have some important aspect of life in common while health care is about ensuring physical, mental and spiritual well being. The amalgamation of both leaves us with the concept of community health which basically refers to meeting the needs of society by identifying the problem and managing interpersonal communication within the community. The spectrum of the role that a nurse plays in a community setting is broader as compared to nursing an individual. A community nursing system not only focuses on care provision, but also encompasses the tasks of managing, leading, promoting, researching and educating the community as a whole. The practice of community health nursing covers residential and occupational settings, schools and ambulatory care. Nursing theorists argue that unlike individual nursing systems, community nursing is a very population oriented one and is practiced in an environmental context.

Implications:

It is an already established notion that nursing theories provide a base and direction for nursing practice. Self Care Deficit Nursing Theories are primarily focused on the interpersonal relationship and efficient communication between the dependant and the nurse. In this context nursing theories can only be implemented effectively if it is made a part of a standardized practice in the organization and a cohesive commitment from the nursing staff can be ensured. Failure to adhere to the standardized nursing system and relying on a trial and error method may put the patient’s life at stake. Furthermore, it may result in the development of trust deficit between patients and the care providers.