Introduction
The article reviews quantitative research studies on home-based families to care for frail and ageing patients. Stajduhar et al. (573) reviewed 129 studies on home-based settings. The authors utilise a systematic approach to exploring studies on home-based care. This paper will analyse the review done by Stajduhar with other researchers.
The question addressed by the systematic review
The paper provides a detailed description of the research problem. A research question is detailed to support the research objectives. For instance, the paper aims to provide a review of quantitative research conducted between 1998 and 2008 on home-based family care. This involved patients with terminal conditions such as cancer among others. Specifically, the paper targets the elders who are given home-based care.
In essence, the authors provide a wide scope of research with causal outcomes. The research questions in the paper are both concise and clear. The topic covered is highly relevant in nursing practices. Home-based care is a significant area of research and practice in nursing. The main caregivers comprise nursing staff. In essence, home-based practise is practically the field of work performed by nurses. In addition, the topic covers crucial terminal diseases such as cancer (Stajduhar et al. 573).
Reviewers allude to the ambiguity of some concepts that include needs, end of life and family caregiving among others. However, the variables and phenomena are defined adequately. In addressing the problem, the authors provided a comprehensive definition and distinguishing features evident in home-based care. Moreover, the review excludes unidentified caregivers in the study. The authors utilise a systematic approach in targeting studies focused on home settings and family caregivers. In addition, the approach is adequately defined and explored to realise a reliable outcome.
The approach utilised is appropriate for providing dependable results on quantitative research studies (Stajduhar et al. 574). Moreover, the approach implemented has revealed the challenges faced in the analysis of home-based caregiving research. Therefore, the paper is succinct with clear and particulate findings along with the recommendations aiming at transforming home-based care. Therefore, the paper is significant to policymakers, clinicians, and other researchers (Teing 104).
Is it unlikely that important relevant studies were missed?
The paper provides a detailed review of a variety of information for family caregiving. In addition, the paper provides a systematic approach to selecting studies. For instance, the first inclusion criteria ensured that the studies’ targeted samples focused on family caregivers. Moreover, the articles chosen were to address the terminal, palliative, or advanced stage. Two pieces of research were selected following recruitment details carried out through the inclusion process. Besides, the criteria chosen were appropriate because they sought to provide a wide area of study and focus on the research problem. In addition, a proper criterion was important in excluding irrelevant or unsupportive material.
The authors utilised articles from several credible databases to provide a comprehensive review of the topic. These included articles from Medline, PubMed, Science Direct, SAGE, PSYC articles, Geobase, and AARP Ageline among others. Therefore, the paper was written after thorough research on those bibliographic databases. The articles were comprehensive and were chosen wisely. In fact, coverage of the issue was deep and provided an all-encompassing review of sources. Moreover, articles were selected and arranged as necessary for a comprehensive and quality review to be done. Notably, the sources used varied from articles to books and government reports. The articles were, also, split and repeated for consistency. Detailed results gained from analysing the articles and utilised sources are provided in the paper with statistics on incorporated information (Stajduhar 574).
The criteria used to select articles for inclusion
The paper used keywords as search criteria. The use of keywords was essential in determining the relevancy of analysed research studies. In addition, it was applied to exclude research concentrated on dying patients who are given family care in facility settings. However, the research included samples from bereavement due to significant concern for the reviewers. In addition, reviewers utilised information from mixed research with quantitative outcomes to provide a review. However, most of the paper was based on quantitative research. Furthermore, reviewers used supplementary efforts to identify relevant materials. The paper, therefore, involved the exclusion of non-peer-reviewed and non-empirical studies. In addition, restrictions included the writing language of articles especially those deviating from English.
These articles were selected to focus on measurement validation and development. Although charts were not utilised to summarise results and search strategy, a detailed descriptive table was provided to suffice the purpose. Essentially, a tabular summary of all the articles utilised was provided. As mentioned earlier, studies that applied a mixture of research to get quantitative results were used. However, the review focused on quantitative research only. Nonetheless, the mixed research was, also, appropriate for review because the papers contained quantitative findings (Stajduhar et al. 574–575).
Studies sufficiency for the investigation
According to Stajduhar et al. (574), a conclusive criterion for appraising the quality of primary studies was utilised to arrive at the best conclusion. Inclusion was carried out in five steps with further exclusion methods mentioned at the end (Stajduhar, et al. 575). The level of solemnity was put to ensure the use of credible sources only as manifested in the outcome of the review. For instance, a detailed coverage utilised in the results section showed that the sources selected were relevant to the topic of study. Moreover, the reviewers applied a well-defined criterion to examine sources to be used in the review thoroughly.
These criteria were succinct and elaborative on the research problem. In addition, the level of appraisal implemented for the papers were top-notch. In fact, bibliographical texts and articles were essential in raising the level of appraisal. At every stage, the researchers worked together to accord different experiences gained from particulate areas to perform the inclusion and exclusion process. In all the cases, no element of disagreement was noted. Therefore, the appraisal conducted was worthwhile, concise and clear. Moreover, the appraisal conducted was dependable, top-notch and defensible. This appraisal portrayed a well-defined selection criterion for study materials (Polit and Beck 20).
Results similarity
Results from the studies reviewed were conspicuously different. In fact, the definition of terms such as needs, end of life, and family caregiving was found to be used inappropriately in some of the researches understudies. The authors, also, noted methodological challenges in bivariate analyses and convenience samples. However, no chi-square was created to establish homogeneity in results. Therefore, the effect of homogeneity was not fully achieved as expected (Stajduhar et al. 576-577). Little was done to establish homogeneity in the studies. Nonetheless, the disparity was common because the review exposed various faults exemplified by varying definitions of terms (Tricco, Straus and Moher 4).
According to the review, 123 articles were identified (Stajduhar et al. 576). 17 of those articles involved mixed methods of research with quantitative findings (Stajduhar et al., 576). Methodological characteristics of the articles reviewed were obtained and tabled in the results section. About 67 % of the studies were found to ignore the definition of “caregiving” (Stajduhar et al. 576). In addition, 20 % of the studies defined a caregiver as the one who provides the majority of tasks in a patient’s care (Stajduhar et al. 576). On the other hand, six percent of the studies identified a caregiver as a person who assumes the most responsibility for caregiving.
Finally, seven percent of the studies provided other alternative definitions of caregiving (Stajduhar et al. 576). The samples utilised were non-random. They were obtained from volunteers. Results, also, showed the majority of research reviewed (58 %) emphasised caregiving for patients suffering from cancer care (Stajduhar et al. 576). In addition, 55 % of studies reviewed were on current caregivers. On the other hand, 45 % of studies were on bereaved caregivers. Notably, 67 % of studies reviewed contained sample sizes of less than 100 participants.
The researchers agree on the influence of sample sizes on the type of statistical analysis performed. Incidentally, 18 % of reviewed studies utilised univariate or descriptive analyses care (Stajduhar et al. 576). On the other hand, about 37 % of studies applied multivariate analyses care (Stajduhar et al. 576). Data collection was mostly done through questionnaires (55 %) that were either self-administered or mailed. Based on the review, three theoretical frameworks were identified. The models were stress coping, stress process and transactional. About 76% of the reviewed articles did not articulate overtly on theoretical frameworks (Stajduhar et al. 576).
Predictive models included subjective appraisals, coping resources and caregiver characteristics. Results, also, show that analysis was centred on individuals. Others included caregiver-patient dyad and organisational features of care. A succinct synthesis of quantitative findings was, also, carried out. In addition, descriptive tables providing detailed information on the studies were reviewed and results obtained (Stajduhar et al. 578).
Results presentation
The reviewer pointed out that 123 articles were chosen on quantitative research applying seventeen study methods. This depicts revelation of the techniques applied in the comparison of published findings. In fact, the reviewer applied the subtopic of methodological overview. The overview has made comparisons among the presented articles by evaluating the similarities in the findings. For instance, 25 articles defined caregivers in a similar manner or technique.
The collected data were tabulated for comparison reasons. However, the comparison performed on the data was confusing. The table seemed shoddy and less organised. Probably, definitive techniques should have been applied to show clear data categorization. There were several categories applied in the data description. The categories were about reference pages, the number of articles and characters. The initial tabulated data was assessed further and transformed synergistically into 3 tables. This data transformation assisted to break down the initial data into more explicit and defined parts.
Consequently, the transformation of data was vital in revealing the existing deviations and similarities. Therefore, a transformation could be identified as an appropriate strategy for the review. However, the abstract had pointed out that a review was undertaken on 129 articles (Stajduhar et al. 576). This deviates from the results of 123 articles presented. This, therefore, requires modifications to facilitate the preciseness of the report.
The data comparisons performed were able to avail the sizes of similarities and dissimilarities in the chosen articles. The effect size computations were apparent due to the listing of tallied articles per an identified character. For instance, 67% (82 articles) of the articles had an undefined or minimal definition of the term caregiver (Stajduhar et al. 577). Knowledge advances are apparent in this article due to the derivation performed from the data.
The discussion is complemented with logical and supported artefacts that raise new ideas. For instance, definitions of caregiving, a family caregiver at end of life, palliative care, and institutional care among others were distinguished. The discussion has a proven ground because there are practical reviews on published articles. In fact, there are references before ideas retrieved from authors.
Results validity
The conclusion of this research was not presented properly. First, the reviewer included the conclusion under discussion. Research should have a clear and identifiable conclusion (Melnyk and Ellen 546). This could have been accomplished by forming a subtopic of conclusion. Secondly, the conclusion did not refer to the qualitative structure, consistency and quantitative aspects of the research that were performed. This conclusion failed to state the limitations of the review and the relationships between nursing and the presented discussion. Finally, a vital aspect of research involving recommending further research was not pointed out in the conclusion. Therefore, this research calls for a better conclusion than the prevailing one. A discussion should not include conclusive information (DiCenso, Guyatt and Ciliska 65).
Conclusion
The fundamental relationship between care results and predictor variables should be determined. A review of 123 research studies has called for comprehensive research to establish a clear definition for the above-named terms. The review has, also, raised a need for further research on home-based caregiving.
Works Cited
DiCenso, Alba, Gordon Guyatt, and Donna Ciliska. Evidence-based nursing: a guide to clinical practice. St. Louis, MO: Elsevier Mosby, 2005. Print.
Melnyk, Bernadette, and Ellen Overholt. Evidence-based practice in nursing & healthcare: a guide to best practice. Philadelphia: Lippincott Williams & Wilkins, 2005. Print.
Polit, Denise, and Beck Cheryl. Nursing Research Generating and Assesing Evidence for Nursing Practice. 8th. ed. Philadelphia, Los Angeles: Wolters Klower, 2012. Print.
Stajduhar, Kelli, Funk Laura, Toye Christine, Grande Gunn, Aoun Samar and Todd Chris. “Home-based family care-giving at the end of life: a comprehensive review of published quantitative research.” Palliative Medicine 24.6 (2010): 573-593. Print.
Teing, Leong. “Systematic Review Made Simple for Nurses.” SGH Proceedings 16.2 (2007): 573–593. Print.
Tricco, Andrea, Straus Sharon, and Moher David. “How can we improve the interpretation of systematic reviews.” BMC Medicine 9.31 (2011): 1-4. Print.