Critique of a research article on Jean Watson,s theory of caring

Critique of a research article on Jean Watson,s theory of caring
Study design
The researchers used a qualitative study design to address the research question. The PICO components of the research questions were focused. The target population of the study was Turkish women diagnosed with infertility. The intervention of the study was the provision of nursing care based on Jean Watson’s Theory of Human Caring. The comparator in the study was standard nursing care without integration of the Theory of Human Caring. The expected outcome was low levels of depression and anxiety common in this target population due to the diagnosis of infertility.

The assignment of study participants to their respective study groups was randomized. The participants who met the inclusion criteria were initially recruited via purposive sampling method. 45 Turkish women were then allocated in the intervention group, while 41 Turkish women were in the control group (Ozan & Okumus, 2017). The study reports that all participants were blinded to assignments to these groups. Block randomization was used to conceal information regarding the process (Ozan & Okumus, 2017). In block randomization, the design allows the investigators to choose and categorize participants into several groups or conditions to minimize selection bias. An external person who was not involved in the study was used to determine the intervention and control groups. The allocation sequence was concealed from the researchers as they were given the group distributions in opaque envelopes that were numbered and had been prepared previously. These processes contributed significantly to minimizing the systematic bias.

The study clearly accounts for all the participants at the end of the study. It also clearly outlines the follow-up procedures conducted during the study. It reports that the study participants were “not left alone before, during, and after the IVF processes- the Oocyte Pick-up (OPU) and Embryo Transfer processes” (Ozan & Okumus, 2017). Following IVF treatment, 32 participants in the intervention group tested negative for the pregnancy, and, therefore, qualified to proceed with the study. The 13 who tested positive did not carry on with the study. In the control group, 5 tested positive and thus did not qualify for further treatment in the study. The study proceeded with 36 participants who tested negative. Phone communication and face-to-face interviews were conducted in the various study groups. In the intervention group, the 32 participants who had negative pregnancy test after IVF treatment were analyzed in their group, after one month of follow-up. However, in the control group, after one month of follow-up, treatment had to be stopped for one participant due to development of complications; therefore, 35 participants were analyzed at the end of the treatment intervention (Ozan & Okumus, 2017).

Both participants and investigators were blind to the interventions administered. This contributed significantly to the internal validity of the study since there were minimum opportunities for variables to be manipulated and impact the study results. However, the article does not mention whether the outcome assessors were also blinded to the processes.

Study methodology

To determine the quality of the study, factors regarding the study methodology are considered. First, both study participants and investigators were ‘blind’ to the interventions administered to the participants. However, the study does not indicate whether the outcome assessors were also ‘blinded’, which might have contributed to systematic bias. The baseline characteristics, used to enroll participants, at the beginning of the study was similar for all participants. The characteristics included primary infertility, being over 18 years, ability to communicate well in Turkish, application of assisted reproductive techniques (Ozan & Okumus, 2017).

The characteristics of the participants at the end of the study were similar as only those who tested negative for pregnancy were qualified to proceed with the study. Both groups were given equal treatments. However, individual appointments were set for each client to prevent them from talking to one another and discussing the study. This eliminated any instances that might have tampered with the study results, thus increasing the internal validity of the study.

Implications for practice

The findings of the study can be integrated in various aspects of nursing practice to improve the outcomes. The study confirms that psychological support plays a significant role in managing depression among individuals undergoing infertility treatments. The results of the study show that there were significantly decreased levels of anxiety, depression in the intervention group. The mean score for anxiety in the intervention group decreased by 13 points, and depression by 14 points (Ozan & Okumus, 2017). Additionally, their mean scores for coping styles also increased compared to the control group (Ozan & Okumus, 2017). This show that the integration of Jean Watson’s Theory of Human Caring was effective in achieving the desired outcomes. The findings of the study can be applied in actual practice by using Jean Watson’s theory as a guide to providing nursing care to patients undergoing infertility treatments to manage their levels of anxiety, depression, and enhance their coping style.

Additionally, the application of this theory in practice can enhance the therapeutic relationship between the healthcare providers and their clients. The study documents that during the interviews, the use of nursing approaches in the theory of human caring significantly improved the processes and enhanced coping mechanisms among the clients. These approaches include “teaching-learning, belief-hope development, problem solving, expression of emotions, help-confidence relationship, and human-needs assistance” (Ozan & Okumus, 2017). Focusing on these approaches have been established to markedly improve coping mechanisms and therefore, can be applied in practice for better management of anxiety, negative emotions and stress related to infertility treatment.

The application of this theory in practice provides a holistic view of nursing care not only in infertility treatment but also in other areas, which contributes significantly to mental, spiritual and physical wellness. It can be applied in crisis prevention programs and in palliative care to improve psychological support among patients.

Further research

While the article confirms the effectiveness of this theory in nursing care, it does not highlight possible areas for further research. I would suggest that a different study population be used, for instance, the effectiveness of integrating the theory of human caring among the elderly (65 years and above) diagnosed with terminal illnesses. Additionally, it is noteworthy that this study did not factor in the patients’ partners when applying infertility treatment. Ideally, couples should be treated together when it comes to reproductive health issues. To demonstrate the effectiveness of this theory in this target population, future research design should be formulated to incorporate couples.

References
Ozan, Y. D., & Okumuş, H. (2017). Effects of nursing care based on Watson’s theory of human caring on anxiety, distress, and coping, when infertility treatment fails: A randomized controlled trial. Journal of caring sciences6(2), 95.

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