Designing Clinical Research

Introduction

This essay entails criticizing an article titled ‘A Theory of Taking Care of Oneself Grounded in Experiences of Homeless Youth’ by Lynn Rew. This article was published in 2003. the purpose of this critique is just to make readers know the details of this article, its merits, make a decision on whether to read it or not, apart from either encouraging other researchers to apply the same criteria like the one employed in the article under critique or not. It also gives specific areas of improvements, as review readers might not have read the article itself.  This criticism will be based on the guideline provided. Such guideline include the criticizing the title, abstract, introduction, literature review, theoretical framework, research questions, methods, population, methods of data collection and measurement, procedures, results, findings, discussion, implications, global issues and Assessment.  The article under criticism is titled.

Title and Abstract

Starting with the title, the Author was much careful to ensure that both the population under study which includes homeless youth. It also clearly states the study problem as ways of taking care of oneself that is grounded in experiences of the population under study. Abstract on the other hand contains the summary of major article features. It contains the summary of the article background which explores the environment through which the population under study strives in. it also contain the major objective of the study as being an exploration of self-care attitudes along with behaviors of homeless adolescent. Abstract also contains a summary of methodology by highlighting sample size along with the methods used in data collection, and methods of analysis. Results have also been summarized in the abstract as being helpful in the social process of providing self-care in an environment termed as much risky. Last but not least, results’ discussion has also been summarized as a suggestion for the nee of further health growth as well as development among adolescent individuals that are homeless.

Introduction

By looking at the article introduction, the author states the problem statement in a decided manner, the author does not coil around many issue to bring out the problem statement. Just after looking what other authors have done, the author states what they have not outlined in their studies. This makes it much easier for the reader to identify it. In addition, the author stated the study’s problem statement at the beginning of the introduction; hence, it takes very short time and energy for the reader to identify the gap that the article tries to breach. Apart from the above mentioned, the problem statement clearly states that, the population under study is homeless youths. It clearly outlines the concepts of self-care in the field of nursing along width the history of self-care theory.

Literature Review

The articles literature review is up-to-date. This is based on the fact that, since the article was published in 2003, and the latest resource that was used was published in 2002, and the earliest resource was published in 1985, while the majority of resources were published between 1994 and 2001, then it is true that the materials were up-to-date. By considering the number of resources used, the content of the review like the history of the problem under study, then it is good to conclude that the literature review is thorough. It has touched all the relevant areas like strategies used by homeless individuals, involvement of homeless people in health promotion among other areas. Apart from the content and the years of publications of resources used in this study, the author ensured that, in the literature review, only primary sources have been used. For instance, the Review carried Rew in 2000, where in which homeless youths were interviewed, and the results found that there were numerous strategies like making friends in dealing with stresses as well as loneliness that is part and parcel of street life. These primary sources are much useful in the study as they have not been tampered with by anybody else; they are just exactly what the researcher got from the field. This provides a real reflection of what one expects in the field.

The author of the article was much keen by ensuring that, the review has summarized the available knowledge on both independent and dependent variables. It also provides a summary of the relation between such variables. It provides a clear statement that due to dangerous and stressful environments through which homeless adolescent live, they are usually vulnerable to poor health. This implies that, poor health is a variable which depends on the environment in which people live. This is much helpful when analyzing and discussing results.   

Theoretical Framework

The author used a ground theory design as a theoretical framework tool. It was very appropriate as it helped much in the process of addressing the behavior patterns both within and between members of certain social group.

Research Questions

In the article the two research questions were “What help you remain healthy living as you do? (b) What would you like to tell me about how you take care of yourself?” (Rew, 2003) Which were explicitly stated? These questions have been worded appropriately as they target to explore the experiences and strategies used by homeless youths to survive in their dangerous and risky environment. such questions can be described as being feasible as they contain a number of subjects and manageable in scope; interesting as they intrigues both the investigator and participants; novel as they all provide new findings apart from confirming, refuting or even extending previous results; ethical as they were approved by the institutional review board; relevant as they are scientific, helps in the formulation of nursing policies as well as giving room for further research, (Hulley, et al. 2007).

In addition, the research questions were consistent with the literature review and conceptual framework. This is based on the fact that, they were trying to explain behaviors within and between homeless individuals, along with survival strategies used by homeless individuals discussed in the literature review.

Methods

However, coming to look at data collection points, it can be seen as not being much appropriate. This is because, choosing just one point of data collection, was not sufficient. There should have been more points at different places. Choosing the church basement was a good idea, but there are those having bad perception towards the church. this perception is because some of these homeless youths were once taken up by church owned homecare and were mistreated, hence will not come again. However, both external and internal validity threats were minimized by the inclusion of three other participants who were recruited width the aim of verifying the results. The number of years such additional participants had lived homeless, and the environments in which they have lived control the threats.

Population

The population under study was identified and described as homeless youths who were living temporarily in urban centers. The sample was also described in details as youths looking for health and social services from street outreach program in Texas. There age was described as between 16-20 years, and having the capability of speaking and understanding English. The sample size was described as fifteen youths comprising of “7 males, 6 females, and 2 transgendered”, (Rew, 2003). Though it can be perceived as being small, but according to the study, saturation was reached at 12^th participant, hence it can be described as being enough, (Mitchell, & Jolley, 2001).

Data collection and measurement

Though the author mentioned key words in the research, but there are no operational and conceptual definitions in the article. Interview has also been mentioned as being the data collection instrument, but there is no explanation on the reason that made the researcher to select this instrument other than other techniques. Furthermore, there are no explanations on the short comings of this instrument. The instrument was sufficient as according to the results provided, the investigator was in a position of asking detailed questions as well as ambiguity clarification. The investigator was also in a position of observing facial impressions which indicates the truth in the message being delivered. Though the report does not clearly state that data was valid and reliable, but going with the methodology explanation like attaining saturation point, volunteer and inclusion of three more participants, proves the fact that collected data was valid and reliable, (Nichols, 1991).

Procedure

There were no interventions during and after the interview, but the investigator followed due process in safeguarding the rights of all participants. For instance, the participants were told about the study and its purpose in advance, participants volunteered themselves and every participant received the written consent. The interview was also conducted in a private area, and tape-recording was only done after the participant has allowed it. Nevertheless, there was no using of names, and their information was kept confidential.

Results

Multivariate regression analysis was undertaken to address every research question as the investigator was attempting to determine formulas that describes ways through which elements in a vector of variables were responding simultaneously to changes in each other, (Mardia, et al, 1979). Moreover, constant comparative methods used in the development of open coding, categories, and analytical memos; along with the use of NUD*IST Q5 software program were sufficient analytical methods based on the measurement levels along with number of groups that were being compared.

Findings

In the study, the findings were summarized into tables and figures as shown figure 1 and table 1. Such findings provided very strong evidence concerning research question, as they all provide strategies through which homeless individuals take care of themselves to remain health with limited resources and becoming aware of them. Due to the fact that the sample size was not too large, then type I and type II errors were not minimized, (Betz, & Gabriel, 1978).

Discussion

The author has interpreted and discussed all major findings which are in line with self-care attitudes and behaviors of homeless adolescents. this is because, the author has discussed the how such youths finds themselves homeless, problems they face and the strategies of dealing with some of such problems to ensure that are staying healthy and focused. Concerning the issues of generalizability, the author admits that, though there are behaviors that can be generalized; there are some which can’t, like carrying weapons.

Recommendations

The investigator points out very important and complete recommendation about the study by saying that “Findings suggest that programs that support healthy growth and development in homeless youths are needed. Such programs can build on the self-care attitudes and behaviors the adolescents learned from taking care of themselves in a high-risk environment” (Rew, 2003).

Global Issues

Due to the fact that the report was well outlined and organized, it was sufficiently detailed for anybody to carry out a critical analysis concerning it. Due to simple language used I was able to understand and comprehend the study. However, the report is not written in a manner that makes its findings accessible to nurse practices, other than psychologists. This is based on the fact that, most of the issues brought out directly from the report deals with psychology, other than nursing practices.

Summary

In summary, the study findings are much valid and I have confidence in the truth value of the results, even if the sample size was too small. Moreover, this study is much useful to the nursing discipline as it provides room for nurses to carry out researches on who they can improve health status of homeless individuals.