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Appraisal Of Qualitative Studies

Why is it necessary to critique a qualitative study? Powers (2011a) states, “All scientific evidence is important to clinical decision making, and all evidence must be critically appraised to determine its contribution to that decision making” (p. 135). A qualitative study attempts to describe an experience from the participant’s perspective. Additionally, to enhance understanding, the objective of a qualitative study is to increase awareness of human experiences.

Performing a critical appraisal of qualitative research requires knowledge of philosophical foundations, the different approaches, and empathy for the perspective of the participant involved (Grove, Burns, & Gray, 2013; Powers, 2011b). For this evaluation, Phoenix, Griffin, and Smith’s (2015) article, “Physical activity among older adults with sight loss: a qualitative research study to inform policy and practice” will be appraised using critical appraisal guidelines for qualitative studies as outlined in The Practice of Nursing Research: Appraisal, Synthesis, and Generation of Evidence (Grove et al. 2013).

Problem Statement Sight loss in those age 60 or older is prevalent, and those with sight impairment are less likely to engage in physical activity. Physical activity can benefit general health and prevent secondary complications that those with visual impairment are at higher risk for (Phoenix et al. , 2015).

Phoenix et al. , 2015 explains: It is important to fill this knowledge gap because public health practitioners and managers cannot assume that what is known about one population (e. g. lder sighted people/young physically active/young visually impaired people) can simply be imported into recommendations for promoting physical activity for another (e. g. older adults with sight loss). (p. 125) The authors do not allude to any personal connection or motivation for this particular research topic. Purpose and Research Questions The purpose of this qualitative study was to “investigate the ways in which participation in physical activity could be prevented or facilitated among older people with acquired sight loss later in life” (Phoenix et al. 2015, p. 125).

The biggest question related to the problem that this study was designed to answer can be formulated from the purpose just stated; are there ways in which participation in physical activity could be prevented or facilitated among older people with sight loss? The qualitative methods are appropriate in answering the research question because they utilized the interview process which gives the experience of the participant. Literature Review

The author utilized several types of literature relevant to the focus of the study. Some types of literature included: statistics, United Kingdom Department of Health, qualitative studies, longitudinal studies, and evidence reviews. The 25 references are current and fall within 10 years of the study. The disciplines utilized for this study all appear to center around health with focus on older adults. The authors did not evaluate or indicate weaknesses of the studies utilized.

The lack of research published advising why older adults with sight loss do not participate in physical activity supports the need for this study (Phoenix et al. , 2015). Philosophical Foundation The authors do not identify a specific perspective or philosopher from which the study was developed, however they clearly utilize an exploratory-descriptive qualitative approach. Grove et al. (2013) explains that, “The philosophy of pragmatism and the naturalistic and interpretive orientations guide exploratory-descriptive qualitative studies” (p. 9).

In the concluding remarks the authors present the social relational model of disability in correlation with their recommendations for health policy, and they cite from Carol Thomas’ Sociologies of Disability and Illness: Contested Ideas in Disability Studies and Medical Sociology (Thomas, 2007; Phoenix et al. , 2015). Qualitative Approach The research approach implied is the exploratory-descriptive qualitative approach, and the methods of the study are consistent with this approach.

According to Grove et al. 2013), “an exploratory-descriptive qualitative researcher often indicates that a study is needed with a specific population to understand the needs of, desired outcomes of, or views on appropriate interventions held by the members of the group” (p. 66). Sampling and Sample Participants were selected by a purposive sampling strategy within England at local site loss organizations and via advertisements in talking newspapers. The inclusion criteria was acquired site loss and age 60 or older. The participants were divided, there were 24 males and 24 females.

The 48 total participants were able to provide relevant data to the study purpose, and there were no participant losses identified in the study results (Phoenix et al. , 2015). Data Collection The data collected in this study was done via interview, this method was utilized because “when done well, interviewing can generate rich, retrospective, and thick descriptions of human life” (Phoenix et al. , 2015, p. 127). There was no indicated time frame for when the data collection occurred. The participants were able to choose the location of their interview and the interviews were digitally recorded and written out verbatim.

Phoenix et al. , 2015 explained: An interview guide was used to help facilitate discussion. Questions included in the guide were, ‘Why did you decide to be physically active? ’, ‘Why have you not been physically active? ’, ‘What are some barriers to your physical activity? ’, “How does being active impact on your wellbeing? ’ and ‘How have you remained active? ’ Clarification, elaboration, and detail oriented probes, that is, curiosity-driven follow-up questions were used throughout to elicit richer data. (p. 127)

The authors did not describe any changes being made in the methods in response to the context and early data collection. Some flexibility was allowed when curiosity-driven follow-up questions were used (Phoenix et al. , 2015). Protection of Human Subjects The authors did not identify the benefits and risks for participation in this study. There were no recruitment and consent techniques identified to accommodate the sensitivity of the subject matter and psychological distress of potential participants, nor in acknowledgement of participant sensitivity and vulnerability.

Data Management and Analysis This study was guided by a list of criteria from “Qualitative Quality: Eight ‘Big-Tent’ Criteria for Excellent Qualitative Research” that fit the research purposes and data which included: worthy topic, rich rigor, sincerity, credibility, resonance, significant contribution, ethics, and meaningful coherence (Tracy, 2010; Phoenix et al. , 2015). The authors describe an audit trail being used by a researcher that practiced reflexivity and kept a journal. Additionally, to minimize the effects of bias an independent advisory board was included.

It was “comprised of five researchers who have published extensively on ageing, disability or physical activity, three representatives of relevant non-profit organizations, and two older adults with visual impairment” (Phoenix et al. , 2015, p. 127). Findings The findings addressed the purpose of the study and were analyzed sufficiently. The authors concluded that, “The analysis revealed several themes that helped to explain why physical activity was prevented or facilitated among older adults with a visual impairment” (Phoenix et al. , 2015, p. 127).

The interpretations of data are congruent with data collected and present a barrier and facilitator to physical activity under these identified themes: environments; organizational opportunities; transport; information; confidence, fear, and personal safety; and exercise is medicine (Phoenix et al. , 2015). There were no variations addressed in the findings. Discussion The results offer new information about the target phenomenon that aids to “fill an important gap within peer-reviewed research literature” on physical activity in older adults with visual impairment (Phoenix et al. , 2015, p. 129).

The findings were not linked to findings in other studies. Several evidence-based recommendations for health policy were offered that include: change being targeted at an environmental or structural level; engage community and commercial stakeholders to promote compliance to anti-discrimination laws; opportunities to participate in different levels or forms of activity; information and guideline education that promote positive physical activity behavior; and, service providers should provide options for participating in local site loss organizations with existing community activities (Phoenix et al. 2015, p. 129).

Logic Form of Findings Readers are able to hear the voice of the participants and gain understanding of the subject studied, because the authors use excerpts from the interviews. Additionally, readers are able to easily identify the elements of the research within the report layout, and the overall presentation fits the purpose, method, and findings of the study. Evaluation Summary According to Grove et al. (2013), “Philosophical congruence, methodological coherence, intuitive comprehension, and intellectual contribution are evaluative standards for qualitative studies” (p. 66).

Philosophical Congruence The initial philosophical foundation from which the study was developed is not explicitly stated, however it is clear that the authors utilized an exploratory-descriptive qualitative approach. Later in the study, the authors utilize the social relational model of disability and the data to state “recommendations for health policy are offered promoting physical activity among older adults with sight loss” (Phoenix et al. , 2015, p. 129).

They acknowledge that the model hasn’t been used in direct correlation of sight loss, but that it could hold great potential for health policy formation (Phoenix et al. , 2015). Methodological Coherence The data collection, analysis, and interpretation processes fit together to form a coherent approach to address ways in which physical activity in older adults with sight loss could be facilitated or ways it is prevented. The use of interviews gives a first person experience to the questions, which allows the readers to gain insight into barriers that must be addressed in the recommendation to health policy subject matter.

Intuitive Comprehension The study is limited in that the population is a total of 48 participants in England. However, understanding that older adults may have more difficulty in physical activity, this particular study gives benefit not only to the nursing practice but also to physical therapy as well. Intellectual Contribution The findings contribute valid recommendations to health policy that can be utilized not only in England but universally.

In closing, the critical appraisal of research involves examination of all parts of the study included above. The purpose of this qualitative study was to “investigate the ways in which participation in physical activity could be prevented or facilitated among older people with acquired sight loss” (Phoenix et al. , 2016, p. 125). The authors were able to complete their study with a positive contribution to research, as there was a gap within peer-reviewed literature on the topic.

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