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Fall Prevention in Aging Patients: Education of Patients

Introduction

The problem of managing and preventing falls from happening in aging patients remains one of the core focuses of contemporary nursing. Therefore, studying the approaches toward managing falls is needed to examine the existing options and defining the most relevant and effective method of fall prevention.

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Methodologies and Designs

The methodologies used in the articles represent the qualitative, quantitative, and mixed methods respectively. For instance, the study by Tan et al. (2019) provides an example of a randomized controlled trial (RCT), where the efficacy of the fall prevention decision tool is examined. The positivism framework, the application of deduction, and the use of the longitudinal strategy make the paper particularly important in evaluating the benefits of the fall prevention decision tool.

In turn, the paper by Finnegan, Bruce, and Seers (2019) provides a qualitative assessment of the issue. Namely, the authors study the nature of patients’ willingness to continue fall prevention management. The interpretivism framework and the use of induction to elicit the information about the factors preventing effective fall management provides an insight into the possible avenues for addressing the issue (Dean, 2018). Finally, the research by Watabe et al. (2018) incorporates the elements of both qualitative and quantitative frameworks in its design. Thus, the grounded theory approach was utilized, with the elements of an inductive framework and the principles of positivism applied.

Internal and External Validity Issues

In order to evaluate the feasibility of research results and their legitimacy, one needs to ask oneself a question concerning the external and internal validity of a study. The concept of internal validity is linked to the structure of a paper, whereas the external one implies assessing its findings and their applicability to actual problems (Matthews & Kostelis, 2011). In the context of fall prevention and the nursing strategies for promoting education of patients and their caregivers, the study by Tan et al. (2019) seems to have a significant amount of internal validity.

Similarly, the paper by Finnegan et al. (2019) seems to be structured properly, with key research methods applied appropriately to answer the research question. Finally, the mixed research conducted by Watabe et al. (2018) can also be characterized by high internal validity rates since its research methodology, as well as the analysis and the following discussion, are structured properly.

Likewise, the external validity of each study under analysis is quite high. Namely, the results of each research can be applied to a setting with a similar nursing environment in order to address the issue of falls in aging patients. Arguably, the research by Tan et al. (2019) addresses quite a specific issue, and its results cannot be applied to any nursing setting. Thus, its external validity is slightly lower than those of the articles mentioned above. Nevertheless, if generalizing the outcomes of this study, one will be able to retrieve the results that can technically be applicable to an average nursing environment to address the issue of falls. Therefore, the overall levels of external validity are rather high in the target research papers.

Benefits of Alternative Methodologies and Designs

Each of the articles mentioned above features a unique approach toward methodology by basing its research on the qualitative, quantitative, or mixed research method. As a result, each of the papers in question has an inimitable set of limitations and opportunities that pertain to the particular research method used in each paper. While the research methodologies in the specified articles have been created very carefully by their authors to suit the needs of the article and answer the research question as accurately as possible, alternative research methods can be suggested for each study.

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For example, the paper by Finnegan et al. (2019) could have been performed as a quantitative case study. Namely, the research question could have been shifted toward the assessment of the efficacy of the identified fall prevention models, thus making the methodology of the study inductive and geared toward the analysis of qualitative factors. Similarly, the change toward the opposite method of research would have represented an interesting change for the article by Tan et al. (2019).

By changing the research outcomes in the specified case toward the qualitative ones, one would have been able to evaluate changes in the perception and attitudes of the current state of patient education concerning falls. As a result, obstacles toward the promotion of effective management and prevention of falls in aging patients and their caregivers would have been more effective.

Finally, the mixed research method used by Watabe et al. (2018) deserves a closer look as the possible source of change in the article under analysis. The mixed method used in the study appears to be a fully justified decision since it represents the problem of fall management from both sides. As a result, the opportunities for changing patients’ and caregivers’ attitudes are provided along with the comparison of the available tools (Morse, 2016). However, the use of the mixed method makes the research somewhat cluttered, which suggests that it could benefit from exploring only one side of the problem. Therefore, removing the qualitative assessment and leaving the quantitative one would have been away of simplifying the research outcomes and making them more generalizable and applicable to any environment.

Nevertheless, as they are, the research strategies used in the papers under analysis serve their purpose fine. Each of the methodologies allows answering the research question or proving the research hypothesis completely, thus making the research results accurate and effective in the selected research design. Therefore, the articles can be considered perfect examples of successful analysis performed to answer the research question or prove the research hypothesis.

Conclusion: Summary and Recommendations

The current state of research concerning the issue of falls and their management in elderly people shows that patient and caregiver education could assist in reducing the threat of falls. The studies selected for the analysis have sufficient rates of external validity and can be used to support this paper. Moreover, the three articles chosen for the analysis allow exploring different methodologies for examining the issue of falls. Thus, different perspectives on the problem at hand, including the qualitative, quantitative, and mixed one, are introduced. Although each of the methods listed above has its disadvantages along with benefits, it still represents a suitable way of addressing the research questions and hypothesis set by the authors.

Changing the methods of the research, in turn, would have shifted the focus from one aspect of the study to another. Namely, the transition from a qualitative perspective to the quantitative one and vice versa would imply losing a particular perspective, while gaining insight into another perspective on the issue. Therefore, the methods chosen by the authors inform the gaps in the research and, thus, the further areas to be explored in this paper.

References

Dean, B. A. (2018). The interpretivist and the learner. International Journal of Doctoral Studies, 13, 1-8.

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Finnegan, S., Bruce, J., & Seers, K. (2019). What enables older people to continue with their falls prevention exercises? A qualitative systematic review. BMJ Open, 9(4), 1-7. 

Matthews, T. D., & Kostelis, K. T. (2011). Designing and conducting research in health and human performance. John Wiley & Sons.

Morse, J. M. (2016). Mixed method design: Principles and procedures. Routledge.

Tan, A. C., Clemson, L., Mackenzie, L., Sherrington, C., Roberts, C., Tiedemann, A.,… Simpson, J. M. (2019). Strategies for recruitment in general practice settings: the iSOLVE fall prevention pragmatic cluster randomised controlled trial. BMC Medical Research Methodology, 19(1), 236-248. 

Watabe, T., Suzuki, H., Konuki, Y., Aoki, K., Nagashima, J., & Sako, R. (2018). Beneficial falls in stroke patients: Evaluation using a mixed method design. Topics in Stroke Rehabilitation, 25(2), 137-144. 

Appendix A: Methodologies Comparison

Article Tan et al. (2019) Finnegan et al. (2019) Watabe et al. (2018)
Research Philosophy Positivism Interpretivism Positivism
Theory Development Deduction Induction Deduction; induction
Research Method Quantitative Qualitative Mixed method
Research Strategy      
Research Timescale Longitudinal Cross-sectional Longitudinal; cross-sectional
Data Collection Field notes Systematic literature review Interviews; checklists
Data Analysis iSOLVE Thematic synthesis Retrospective analysis

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