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'Managing communication with young people who have a potentially life threatening chronic illness: qualitative study of patients and parents.'

The following web address contains the paper 'Managing communication with young people who have a potentially life threatening chronic illness: qualitative study of patients and parents.'
http://bmj.com/cgi/content/abstract/326/7384/305

Example of critical appraisal of qualitative research paper

We used the critiquing framework located on this website to sensitise us to the issues in this paper. You will note that our analysis is not merely a series of yes/no answers nor is it a rephrasing of the statements found in the framework. We have taken the points and expanded them into a series of points which are supported by references to research texts.

Young, B., Dixon-Woods, M., Windridge, K., & Heney, D., (2003) Managing communication with young people who have a potentially life threatening chronic illness: qualitative study of patients and parents. BMJ. 326, 305-310

This is a well-structured and detailed account of qualitative research that investigates communication processes with young people living with a potentially life threatening chronic illness. The researchers use a constant comparative technique to generate data and carry out analysis for themes. The method of data collection includes semi-structured interviews with young people and parents, and reflexive diary keeping by the interviewer and data analyst.

The literature review sets the topic in context and demonstrates the breadth of work available on the issue. From this use of the literature Young et al acknowledge the advantage of taking a multi-disciplinary view on the topic area. Unfortunately, there is no explicit link between the literature review and the research design in terms of theory testing or exploration. This may be seen as a weakness when attempting to place this analysis in a broader context [Robson, 1993].

Young et al provide a very clear and detailed account of the research design and the methods of data collection. The detail provided on the purposeful selection of the sample allows us to follow their decision trail and replicate the study if we so wish in terms of numbers of families accessed, and the ratio of young men to young women interviewed [Parahoo, 1997]. Unfortunately for the study design, the families involved in the research exhibit a high degree of homogeneity [i.e. similar background]. This might be problematic because we may over rely on a certain view of the situation being investigated, and miss themes or concepts that need to be explored [Denzin & Lincoln, 2000]. Data was collected by audio taping interviews and transcription, the word processed files then being analysed using NUD*IST software. NUD*IST software structures the data in terms of hierarchical relationships which may have an effect on the form of the analysis [Tesch, 1990]. The authors do not comment on whether this was a positive or negative element to the analysis. The person who conducted the interviews did not carry out the analysis of the texts. This may have had an impact on the richness of the analysis performed, but steps were taken to maintain the rigour of the interpretation by including another researcher in the process [Strauss & Corbin, 1998]. The use of reflexive diaries augmented the analytical process and this is a good example of iterative activity which is characteristic of this type of work [Hammersley & Atkinson, 1995].

While ethical approval was obtained to carry out the work, Young et al do not comment on the associated ethical issues of autonomy, preventing harm and benefit. It is reasonable to expect them to have commented on how they would respond to distressed young people or parents during the interviews; and to have commented on how they would deal with situations where the interviews may have caused conflict between young people and their parents [Cormack, 2000].

The findings of the research allow us to hear the voices of the participants by including extracts of text from the interviews to illustrate analytical points. This is a very powerful way of maintaining credibility, believability and truthfulness and allows the reader to gain a richer understanding of the issues being discussed [Morse, 1996]. In this section Young et al acknowledge that they do not use concepts such as age or sex to inform their analysis, and this may have a bearing on future work. They also acknowledge that the purposeful sampling strategy may have had an effect on their findings. They make very useful recommendations for practice for health care practitioners working with young people that are based on the findings.

References

Cormack, D., 2000. The research process in nursing 4th ed. Oxford: Blackwell Science.

Denzin., N.K., & Lincoln Y.S., eds. 2000. Handbook of qualitative research. Thousand Oaks, California: Sage.

Hammersley, M., & Atkinson, P., 1995. Ethnography: Principles in practice. London: Routledge.

Morse, J., 1996. Nursing research the application of qualitative approaches 2nd ed. London: Chapman & Hall.

Parahoo, K., 1997. Nursing research principles, process and issues. Basingstoke: Macmillan.

Robson, C., 1993. Real world research a resource for social scientists and practitioner-researchers. Oxford: Blackwell.

Strauss, A., & Corbin, J., 1998 Basics of qualitative research techniques and procedures for developing grounded theory. Newbury Park: Sage.

Tesch, R., 1990. Qualitative research analysis types and software tools. Basingstoke: Falmer Press.