Critical Appraisal 1

CRITICAL APPRAISAL

Student number

Code + Course Name

Professor’s Name

University Name

City, State

Date

Word Count: [1798 words, inclusive of the introduction.]

 Critical Appraisal 2

Critical Appraisal

Introduction

Over the past few years, evidence-based practice has gained popularity as reflected in

the way that it’s now being echoed in education, science as well as in nursing practice. Aveyard

and Sharp (2013) describe evidence-based practice as a process that is backed up by a

rationale that is up-to-date and which is also clear and takes into consideration the preferences

of patients and utilizes one’s own judgment. It involves the utilization of the best current

evidence together with clinical expertise as well as patient values as far as making decisions

during the delivery of care is concerned (Melnyk, Fineout-Overholt , Stillwell & Williamson,

2010). One of the most important processes in evidence-based practice is critical appraisal. By

definition. critical appraisal is the careful, systematic examination of an undertaken research in

order to establish its value, trustworthiness, and relevance (Critical Appraisal Skills Programme

International, 2017). The following is a critical appraisal of an article titled Misconceptions about

smoking in patients with type 2 diabetes mellitus: a qualitative analysis by Chau et al. (2015).

Since it is a qualitative study, the CASP Qualitative Checklist was utilized.

Was there a clear statement of the aims of the research?

Answer: Yes

Chau et al. (2015) gave the clearest description of the researchs’ objectives. They point

out that they intend to use the research to investigate the smoking behaviors, perceptions

related to quitting smoking as well as the factors that are linked to the intention to quit smoking

among patients with type 2 diabetes. Through the statement of the aim of the research, the

authors get to illustrate what their study involved as well as the target population for the

research. This way, anyone reading the article can have a clear picture of what the study was all

(Student Number)
 Critical Appraisal 3

about and the issues that the researchers sought to investigate. A clearly illustrated statement

listing the various aims of the research is one of the most important indicators of the quality of

the research. In order to simplify the research process and hopefully easen the burden of data

collection, the study could be framed in the form of a PICOT question. It would take the form:

For patients diagnosed with type 2 Diabetes, does their perception of cigarettes and previous

smoking behavior influence their feelings towards quitting smoking?

Is the Qualitative methodology appropriate?

Answer: Yes

Chau et al. (2015) affirm that they deployed a qualitative research design for their study.

Since the aim of their study was to gather intelligence on the behaviors and the perspectives of

the population under study, the qualitative research design can be said to be very much

appropriate. While quantitative studies usually seek to confirm an argument or hypothesis about

a given phenomenon, qualitative studies seek to explore and gain a better understanding of an

issue (CASP International, 2017). For their research, Chau et al. (2015) make it clear in their

objectives that they seek to better understand the smoking behaviors as well as perceptions of

type 2 diabetes towards smoking.

A qualitative research design is more appropriate when the phenomenon under study is

not well-defined and when researchers want to explain the linkage between two or more factors

as is with the study conducted by Chau et al. (2015). However, a qualitative research design

does not measure nor provide statistical validation. Additionally, a qualitative study cannot be

used as a substitute for a quantitative study in situations where quantitative analysis is needed,

but the researchers face time or budgetary constraints (Lewis, 2015). For Chau et al. (2015) the

phenomenon under study did not require quantitative analysis, meaning that they were right in

their choice of the research design.

(Student Number)
 Critical Appraisal 4

Was the research design appropriate to address the aims of the research?

Answer: Can’t tell

Despite clearly pointing out that they utilized a qualitative research design, the

researchers do not go into details to explain why they settled on this research design as

opposed to what would have been the case with a quantitative research design. During the

process of selecting what research design to use, certain factors must be cinsidered to enable

an informed decision to be made. The item or situation being studied is critical seeing as

different case studies require their own unique research methods. On top of that, the data

collection methods need to be selected before the research design is chosen. Therefore, while

the qualitative approach may seem viable on paper, research methods’ success can only be

evaluated once the results are out seeing as their efficiency varies on a case to case basis.

Was the Recruitment strategy appropriate to the aims of the research?

Answer: Yes

Chau et al. (2015) explain their target population and the recruitment procedure as part

of their submissions. They point out that a total of 42 participants were recruited for the study.

They point out that those recruited had to be individuals diagnosed with type 2 diabetes mellitus

and also had to have a smoking history. However, they do not go into detail as to why the

participants were the most suitable for the study as far as the provision of access to the type of

knowledge that the researchers were seeking is concerned. Chau et al. (2015), offer a brief

discussion around the recruitment process, but do not mention whether the 42 who took part in

the study were the numbers they initially targeted or not.

Purposive sampling was the preferred selection technique seeing it enabled the

researchers to obtain participants who have both diabetes and a smoking history. If random

sampling was applied, the selected partivipants may not have been viable for the study.

(Student Number)
 Critical Appraisal 5

Was the data collected in a way that addressed the research issue?

Answer: Yes

The researchers indicate that to collect data, they utilized semi-structured interviews.

Since the study sought to find out the smoking behaviors among type 2 diabetes patients and

their perception of smoking, a qualitative method such as the semi-structured interview was

quite very appropriate for undertaking it. The focus for this particular research was to deduce

the perception of smoking from the collected group of type 2 diabetes patients accumulated.

Semi-structured interviews were deemed appropriate seeing as they not only allowed the

researchers to prepare their question beforehand but they also made it simpler for the selected

participants to speak freely(Hersen 2011). Chau et al. (2015), point out that the data was

collected from patients recruited at outpatient clinics in two of the biggest local hospitals in Hong

Kong. Despite not clearly stating the exact location where the semi-structured interviews took

place, readers can tell that the data collection setting was in Hong Kong. The researchers also

go to a great length to discuss how the interviews were conducted and to explain some of the

responses given by the participants. To this end, it could be argued that, Chau et al. (2015),

made the methods explicit. They further indicate that they utilized a topic guide in the semi-

structured interview. This way, it was possible to avoid going off-topic and collecting data that

was not relevant to the study.

Has the relationship between researcher and participants been adequately considered?

Answer: Can’t tell

Despite adequately describing the participants and the participation criteria, Chau et al

(2015) do not critically discuss the relationship between the researchers and the participants.

For instance, they fail to indicate how they took into consideration the welfare of the participants

during the formulation of the research questions. The researchers do not also bring to light the

(Student Number)
 Critical Appraisal 6

potential bias and how they managed to bypass the said bias. Chau et al. (2015) do not discuss

any unplanned events that took place in the course of the study. As such, it is difficult to judge

their responses to the said events even if they happened. Reflexivity, the process of one looking

at themselves as a researcher and also in terms of their relatoonship during the research,

(CASP International, 2017), also came into play during the research seeing as the researchers

were responsible for considering what they themselves saw as appropriate. Therefore, a clear

distinction was present between researchers and participants; although there was no bad blood

whatsoever.

Have ethical issues been taken into consideration?

Answer: Yes

The researchers discuss the ethical issues they took into consideration in the course of

their studies. For the recruitment process, they point out that informed consent was obtained

before bringing the participants on board. Chau et al. (2015) also report that they the

participants were assured of their confidentiality and safety in the course of the study. Taking

into consideration ethical issues is of great importance in collaborative work such as the current

study (CASP International, 2017). By ensuring that key ethical issues are considered, the

researchers then were able to establish a good relationship with the participants which in turn

helped strengthen the quality of the study. Upholding high ethical standards usually helps

promote values such as trust, mutual respect, accountability and fairness, which are all

important in as far as collaborative work is concerned (Rossi et al. 2009). Additionally, Aveyard

et al., (2013), highlight that ethical standards help promote the objectives of research such as

truth, knowledge as well the avoidance of errors.

Was the data analysis sufficiently rigorous?

Answer: Yes

(Student Number)
 Critical Appraisal 7

Chau et al. (2015) provides sufficient information describing the data analysis process.

They clearly describe the techniques they utilized in analyzing the collected data and they as

well focus on the results that they obtained after carrying out the semi-structured interviews

which makes the data analysis more accurate. Additionally, there is a clear explanation of how

the data used was selected from the original sample which makes it very easy to establish that

the data analysis was sufficiently adequate.This makes the data analysis consistent because

there was a stable mechanis of collecting data (Ortega, 2018). Similarly, their research

managed to reach data saturation; an affirmation of the quality of their qualitative study. As in

most researches, the success is gauged by how much data was accumulated and whether or

not it is relevant to the study. Data saturation is prove that data was comprehensive, which

confirms both the aforementioned questions have favorable answers and therefore the research

was successful.

Is there a clear statement of findings?

Answer: Yes

Chau et al. (2015) provide a clear statement of what can be drawn from the results they

obtained. They point out that based on the results, inadequate knowledge, and satisfaction with

health status as well as misconceptions about health status all contribute to the negative

attitude towards quitting smoking among patients with type 2 diabetes. The researchers make

the findings explicit by discussing them in-depth and highlighting how the said findings relate to

the original research question.

How valuable is the researcher?

The authors point out that the findings from the study make a great contribution to

knowledge and existing literature on smoking and its linkage to type 2 diabetes. Chau et al.

(2015) point out that their study reveals the importance of raising health awareness as well as

(Student Number)
 Critical Appraisal 8

addressing popular misconceptions regarding quitting smoking. They propose that weight

control strategies and behavioral counseling should be integral components of smoking

cessation programs that target patients diagnosed with type 2 diabetes. On top of that, the

effect of nicotine on worsening any pre existing complications from the type 2 diabetes may be

eliminated with cessation. As such, it can be argued that the study makes quite a significant

contribution to the current research and is therefore of great value.

(Student Number)
 Critical Appraisal 9

References List

Aveyard, H. and Sharp, P., 2013. A beginner's guide to evidence-based practice in health and

social care. McGraw-Hill Education (UK).

Chau, T.K., Fong, D.Y.T., Chan, S.S.C., Wong, J.Y.H., Li, W.H.C., Tan, K.C.B., Leung, A.Y.M.,

Wong, D.C.N., Leung, D.Y.P. and Lam, T.H., 2015. Misconceptions about smoking in

patients with type 2 diabetes mellitus: a qualitative analysis. Journal of clinical nursing,

24(17-18), pp.2545-2553.

Critical Appraisal Skills Programme (CASP), (2017). CASP (Qualitative Research) Checklist.

[online] Available at:

http://docs.wixstatic.com/ugd/dded87_25658615020e427da194a325e7773d42.pdf .

Accessed: 23rd Feb, 2018.

Hersen, M., 2011. Clinician's handbook of adult behavioral assessment. Gulf Professional

Publishing.

Lewis, S., 2015. Qualitative inquiry and research design: Choosing among five approaches.

Health promotion practice, 16(4), pp.473-475.

Melnyk, B.M., Fineout-Overholt, E., Stillwell, S.B. and Williamson, K.M., 2010. Evidence-based

practice: step by step: the seven steps of evidence-based practice. AJN The American

Journal of Nursing, 110(1), pp.51-53.

Rossi, S., Hallett, M., Rossini, P.M. and Pascual-Leone, A., 2009. Safety, ethical considerations,

and application guidelines for the use of transcranial magnetic stimulation in clinical

practice and research. Clinical neurophysiology, 120(12), pp.2008-2039.

Ortega, D. (2018). Seven Characteristics That Define Quality Data - Blazent. [online] Blazent.

Available at: http://www.blazent.com/seven-characteristics-define-quality-data/

[Accessed 5 Apr. 2018].

(Student Number)
 Critical Appraisal 10

(Student Number)