NR 439 Week 6 Assignment 3 – Research Article Critique Paper 3 (Types of Photographic Art Preferred by Cancer Patients)
Receiving the diagnosis of cancer can be extremely devastating to people. Nearly 1,735,350 people will receive diagnosed of cancer in this country; of these people, 609,640 people will die as a result of the cancer (National Cancer Institute, 2018). As they undergo cancer treatments, cancer patients experience a wide range of emotions, such as anger, depression, fear, sadness, & dejectedness. These emotions can lead to further deterioration of these patients. Most of these patients will spend an immense amount of time in the hospital to receive treatments & care. Nurses provide the bulk of the care for these patients. This care involves the care for the whole patient– mind, body, soul, & emotions. One of the founders of modern nursing, Florence Nightingale, wrote that a person’s surroundings have a vital impact on physical health, recovery, & mental health (Hanson, Schroeter, Hanson, Asmus, & Grossman, 2013).
Recently, researchers published a study in which photographic art was researched to examine its possible effects on cancer patients who were hospitalized. They wanted to know if photographic art would benefit the health of these patients (Hanson, Schroeter, Hanson, Asmus, & Grossman, 2013). The researchers had two purposes in this study. First, they wanted to know the types of photographic art that cancer patients prefer. Second, they desired to know the patients’ perceptions after seeing the photographic art (Hanson, Schroeter et al., 2013). They would want to identify if the art was beneficial or negative to the patients. This manuscript will investigate the dynamics of the research study process by exploring the research question, research design, sample, data collection methods, and possible limitations and findings. The manuscript will delve into the mechanics of how & why the research question was created for this study.
Dynamics of the Research Question
What is a research question? Research questions outline the main parts that need to be researched & then direct the design & data collection methods of the research (Houser, 2018). The researchers of this study formed questions that were specific to the purpose of the study. The purpose of this study was to identify the types of photographic art that cancer patients preferred as well as the patients’ perceptions after seeing the photographic art. Research has already proven that “high-quality aesthetic art gives one positive emotion while looking at low quality evokes negative feelings” (Hanson et al., 2013, pg. 338). When people respond either negatively or positively to art, they will experience either a negative or positive impact on their health (Hanson et al., 2013). Earlier studies, which were done in 1984, demonstrated that patients who viewed art depicting nature scenes had shorter hospital visits & fewer reports of pain levels Hanson, Schroeter et al., 2013).
Simply stated, seeing nature has beneficial effects on the health of hospitalized patients. Knowing the results of these earlier studies, the researchers desired to understand the exact photographic art that appeals to cancer patients. Researchers wanted to know how the patients felt when they looked at the photographic art (Hanson et al., 2013). Researchers of this study wanted to understand the categories of photographs patients preferred (Hanson et al., 2013). They also wanted to know the categories of photographs that patients did not like. Finally, researchers sought to discover the types of delivery formats patients want to see the pictures in (Hanson et al., 2013).
“Photographic artworks by distracting people from their current unpleasant or noxious situation or by relieving mental fatigue & restoring the person “(Hanson et al., 2013, pg 339). The research questions were thorough & detailed. However, the researchers did not account for the cancer patients who have physical or mental limitations to seeing the photographic art. People who are visually impaired would not receive the benefits of this type of therapy. In addition, patients who suffer from conditions such as certain types of brain cancers or severe mental retardation cannot demonstrate whether they have received benefits from the therapy or no benefits. The manuscript will now explore the dynamics of the research design.
NR 439 Week 6 Assignment 3 – Research Article Critique Paper 3 (Types of Photographic Art Preferred by Cancer Patients)
Dynamics of the Research Design
The researchers implemented a wide range of designs for this study. They utilized the “quantitative, exploratory, single-group, post-test descriptive design in addition to incorporating some qualitative survey questions for analysis” (Hanson et al., 2013, pg. 339). Researchers used a convenience sample of eighty cancer patients who were hospitalized (Hanson et al., 2013). The setting for this study was at the hospital. Most of the patients had access to a window where they could see nature (Hanson et al., 2013). However, the rooms lacked photographic art (Hanson et al., 2013). Researchers recorded the gender, diagnosis, length of hospitalization, race, marital status, & age (Hanson et al., 2013). When researchers recorded the length of hospitalization, they listed the beginning as the first day the patients saw the photographic art; they received this information from the unit census report (Hanson et al., 2013).
Researchers implemented the usage of several assessment tools, some of which were scored zero to five (these assessments tested patients’ health status after viewing the art). Other assessment tools asked open-ended questions to assess patients’ preferences. This open-ended assessment tool is an example of qualitative research questions. Per Houser (2018), qualitative research designs “answer questions about the human experience by exploring motives, attitudes, reactions, & perceptions” (pg. 387). During the study, researchers used a DVD that contained sixty photographs, which were demonstrated on laptop computers. The pictures were chosen by the cancer patient advisory board. They thought that photographic art should be “bright, cheerful colors & variety” (Hanson et al.2013, pg 340). Accordingly, the photographic art includes landscapes, water, flowers, animals, landmarks, & entertainment (Hanson et al., 2013).
The research design of this study indicates that the researchers wanted figures that could be scored & that could be described. The writer of this manuscript hypothesizes that the researchers wanted the patient’s preferences in the study in addition to statistical analysis. This research design had both strengths & weaknesses. Its strengths included its usage of both qualitative & quantitative data. They utilized several assessment tools that assessed the patient’s functioning after seeing the photographic art & the patients’ preferences. These assessment tools also evaluated the patients’ own feelings regarding the photographic art by using open-ended questions. The weaknesses of the research involved its sampling. The sample size was eighty, which makes it prone to more errors. In addition, the study did not include patients who were very sick. Finally, the usage of convenience sampling brings with it the possibility of researcher bias. In this study, researchers selected the participants, which heightened the risk of bias (Houser, 2018). The manuscript will now delve in-depth into the sample of this research.
Dynamics of the Sample
Researchers obtained a sample size of eighty cancer patients who were hospitalized at one hospital in Wisconsin (Hanson et al., 2013). Forty-four men & thirty-six women between the ages of nineteen & eighty-five years of age were the participants. These patients spoke English, could look at photographs on a computer screen, & were responsible for their own care (Hanson et al., 2013). These participants were admitted to the blood & marrow transplantation or hematology/oncology services for at least twenty-four hours (Hanson et al., 2013). The admitting diagnosis of most of the patients to these units was myeloma, leukemia, or lymphoma (Hanson et al., 2013). These patients’ average length of hospitalization ranged from six to twelve days (Hanson et al., 2013). Finally, they were in stable medical condition (Hanson et al., 2013).These participants were chosen by researchers after they had been considered eligible.
When nurse researchers are reviewing the sampling area of the research, they must examine the sample selection methods & sample size (Houser, 2018); the sample size was inadequate due to its smallness. Small sample sizes tend to put the results at risk of not being applicable to the rest of the population. The bigger the size, the more it can represent the whole population. With a sample size of only eighty cancer patients, it is hard for researchers to apply the results to the nearly 1,735,350 people who will contract cancer this year. Researchers such as in this study with small sizes are more at risk of being influenced by the extreme values in the study. When researchers implement measures of variability in a study like this one, they will notice a few samples around the mean with a large standard deviation or large errors (Houser, 2018). If they had chosen a larger sample size, they would have had more samples around the mean with a small standard deviation or smaller errors (Houser, 2018). Thus, the writer of this manuscript believes that this research has an inadequate sampling size. The manuscript will now examine the dynamics of the data collection methods of this study.
Dynamics of the Data Collection Methods
The data collectors for this study were registered nurses who worked in the blood & marrow transplantation unit & the hematology & oncology units (Hanson, Schroeter, Hanson, Asmus, & Grossman, 2013). However, these nurses did not collect data from the units where they worked. These nurses ensured that the environment was free from distraction during the data collection. The study was done at the patient’s bedside. The nurses “timed the DVD viewing with a stopwatch” (Hanson, Schroeter, Hanson, Asmus, & Grossman, 2013, pg 341). When the participants finished looking at the 60 photographs, the nurses set up the computers so they could do the Visual Arts Research Survey (Hanson, Schroeter, Hanson, Asmus, & Grossman, 2013). “The survey was conducted via a secure Internet survey site, Qualtrics™. A three-digit identification number was assigned to each participant linking paper & electronic data” (Hanson, Schroeter, Hanson, Asmus, & Grossman, 2013, pg. 341).
The nurses transcribed the paper survey results on the recording sheet with the participant’s identification number (Hanson, Schroeter, Hanson, Asmus, & Grossman, 2013). They later entered this data into the statistical program (Hanson, Schroeter, Hanson, Asmus, & Grossman, 2013). A group of three researchers evaluated the open-ended questions by grouping them into categories & then comparing the categories. They did this by matching the subjects’ responses to categories utilized in the study (flowers, landmarks, animals, landscape, water, & entertainment) (Hanson, Schroeter, Hanson, Asmus, & Grossman, 2013). While categorizing, the researchers discovered three disparate groups: people, spiritual, & imagery (Hanson, Schroeter, Hanson, Asmus, & Grossman, 2013). Despite their best efforts, the data collection methods by these researchers raised a few apprehensions.
One of the concerns raised by these data collection methods involved the apparent lack of informed consent. The study did not indicate that the participants had been told about the Ramifications of the study. The research did not note that the subjects signed an informed consent document. Another concern that the writer of this manuscript noticed was the lack of confidentiality & anonymity of the participants. The study did not state that they had protected the participants’ confidentiality & anonymity other than sending the visitors out of the room. Finally, the researchers transcribed the paper survey onto a recording sheet, which could have led to errors & falsification. The manuscript will now delve into the possible limitations of this study.
Dynamics of the Research’s Limitations
Limitations in a study may prevent the results from being replicated (Houser, 2018). In this study, researchers chose a research sample of eighty subjects, thus limiting the scope of its results being utilized by the entire cancer patient population. A small sampling in research leads to many errors. If the researchers were to replicate this study in the future, they must select a large sample size. Thus, they would minimize the number of errors in the study. In addition, the researchers did not explain the informed consent process of this study. Participants should receive clear, informed consent at the start of the research process (Houser, 2018). They should be told that they can leave the study at any time during the research. The research article did not state that this process had been accomplished.
Still, another limitation of this study was the absence of sick patients. As a result, the research does not show how photographic art would affect sick patients. In the future, the researchers should consider including ill patients in the study. Researchers also had to deal with less than reliable internet access, which lengthened participants’ time (Hanson, Schroeter, Hanson, Asmus, & Grossman, 2013). They also had to deal with confusing forms from the Hollingshead tool, which was supposed to assess fatigue in the subjects (Hanson, Schroeter, Hanson, Asmus, & Grossman, 2013). Researchers had to cancel the usage of this tool, which led to a lack of findings on fatigue levels. Finally, the ethnic makeup of the subjects was heavily slanted toward one racial group. Seventy-two of the eighty participants were Caucasians, while three were African Americans. Two of the subjects were listed as biracial, while the other three were Mexican, Asian, & American Indian. It is difficult to infer the results of a study to a population when other ethnic groups have not been represented well. If the researchers wish to replicate this study in the future, they need a sample that represents the whole population of cancer patients. The manuscript will now discuss the results of this research study.
NR 439 Week 6 Assignment 3 – Research Article Critique Paper 3 (Types of Photographic Art Preferred by Cancer Patients)
Dynamics of the Research’s Findings
The researchers discovered that nature photographs made the participants feel positive & upbeat. Most of the participants loved viewing the photographic art. Subjects liked the photographs of the lake sunset, rocky river, & autumn waterfall (Hanson, Schroeter, Hanson, Asmus, & Grossman, 2013). They tended to dislike photographs of amusement parks, farmer’s markets, & a group of kayakers (Hanson, Schroeter, Hanson, Asmus, & Grossman, 2013). The results revealed that the patient’s emotional health improved in happiness & hopefulness (Hanson, Schroeter, Hanson, Asmus, & Grossman, 2013). Patients stated that the photographs made them feel at peace. Most of them expressed a desire to have similar photographic art on the walls in their hospital rooms. Thus, these patients expressed that they needed a break from their daily schedules of treatment (Hanson, Schroeter, Hanson, Asmus, & Grossman, 2013).
From these findings, researchers inferred that nature scenes could “create a more positively perceived healing environment for their patients” (Hanson, Schroeter, Hanson, Asmus, & Grossman, 2013, pg 343). The findings of this study answered nearly all the research questions. They discovered that patients did enjoy looking at the photographs. They found that the artwork made the patients feel hopeful & positive. Researchers discovered that patients preferred nature scenes. They disliked photographs of amusement parks, farmer’s markets, & kayakers (Hanson et al., 2013). However, researchers did not discover the types of delivery formats that the participants preferred when they looked at the photographs. These findings would have been more credible if they had a larger sample size with a larger ethnicity representation. In addition, the absence of sick cancer patients limits the scope of this study to all cancer patients.
Conclusion
In this manuscript, the writer explored a research study in which photographic art was researched to examine its possible effects on cancer patients who were hospitalized. The research questions of this study included: a) exact type of photographic art that appeals to cancer patients’ emotions while looking at the photographic art, c) categories of photographs patients preferred, d) categories of photographs that patients did not like, & e) discovery of the types of delivery formats patients want to see the pictures in (Hanson et al., 2013). The research design was quantitative & qualitative with a convenience sampling. The sample size was eighty patients, which was a small sample size. Researchers collected data through registered nurses at the patient’s bedside with the usage of computerized surveys. The study was limited by its sampling size, absence of sick patients, minimal ethnic presence, & possible researcher bias. The researchers found that patients preferred nature scenes, which gave them emotions of hopefulness & happiness. These findings emphasize the fact that nurses have the power to affect their patient’s surroundings by manipulating the environment – usage of nature scenes (Hanson et al., 2013). Healing the emotional status can immensely affect the physical status. Since this study has so many limitations & potential errors, the writer of this manuscript believes that this study is not enough to recommend a change in practice (Hanson, Schroeter, Hanson, Asmus, & Grossman, 2013). However, this research study is a positive step in the right direction as nurses seek to provide care to the whole patient. Nurses must always seek to provide holistic care to each of their patients, which includes care to the patients’ minds, souls, bodies, & spirits.
Reference
Hanson, H., Schroeter, K., Hanson, A., Asmus, K., & Grossman, A. (2013). Preferences for photographic art among hospitalized patients with cancer. Oncology Nursing Forum, 40(4), E337-E345. doi:10.1188/13.ONF.E337-E345. Retrieved June 4, 2018 from https://chamberlainuniversity.idm.oclc.org/login? url=http://search.ebscohost.com/login.aspx? direct=true&db=c9h&AN=89013514&site=eds-live&scope=site
Houser, J. (2018). Nursing research: Reading, using, & creating evidence (4th ed.). Burlington, MA: Jones & Bartlett Learning.
National Cancer Institute. (2018, April 27). Cancer Statistics. Retrieved June 5, 2018, from https://www.cancer.gov/about-cancer/understanding/statistics
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Question 
Examine the sources of evidence that contribute to professional nursing practice.
Apply research principles to the interpretation of the content of published research studies.
Evaluate published nursing research for credibility and lab significance related to evidence-based practice and the role of research findings in evidence-based practice.