Research Critiques and PICOT Statement Final Draft
A research critique is important because it enables the identification of the strengths and weaknesses of an article. This guides a researcher to determine the relevance of the articles in the specific topic of study. This critique evaluates two qualitative and two quantitative research articles to evaluate different aspects of the studies. A summary of the studies will be provided, and the relevance of the study to the nursing practice issue identified. Furthermore, this paper will describe the methods and the findings of each of the studies and discuss the ethical considerations upheld by the authors of the articles. Additionally, this paper will make a comparison of the findings of the authors and those of my PICOT question and propose an evidence-based practice change. The main problem is racial discrimination to access proper health care, nutritional, and holistic healthcare services.
Nursing Practice Problem and PICOT Question
The clinical problem is racial discrimination in accessing proper health care. Nutritional and holistic healthcare services. My PICOT question: Among the ethnic minority population, do culturally appropriate care-based interventions versus traditional approaches reduce discrepancies in access to health care services after six months? The two articles will be used to answer the PICOT question.
P: Ethnic minority population
I: culturally appropriate care-based interventions
C: traditional approaches
O: reduce discrepancies in access to health care services
T: six months
Background of the Study
The authors of the qualitative articles are Diaz Rios & Chapman-Novakofski (2018) and Patel et al. (2020). According to Diaz Rios & Chapman-Novakofski (2018), the purpose of the article is to conduct extensive interviews with experience-laden community nutritional researchers in the United States of America to identify the barriers and enablers of recruitment of Latinos and Hispanics and evaluate any beneficial practice that the group enjoys. Group enjoys. The objective of the study is to identify factors that influence participation and evaluate strategies that facilitate access of Latinos and Hispanics to community nutrition research. The research question: What are the factors influencing the participation of Latinos/Hispanics in research from the perspective of community nutrition researchers? The clinical problem is racial discrimination to access proper health care and nutritional and holistic healthcare services. This is significant to nursing practice because nursing personnel should be on the front line of championing equity in health care service provision.
According to Patel et al. (2020), the purpose of their study is to evaluate demographic variations in health insurance knowledge. The objective of the study was to determine the level of understanding of health insurance and the Affordable Care Act among ethnic minorities in the USA. The research question that can be formulated from the study is: what is the impact of a multi-ethnic population on the understanding of health care insurance and the Affordable Care Act? The nursing problem is discrimination against access to health care services by the racial minority. This is significant to nursing practice because nurses should be actively involved in minimizing discrimination by advocating for policies that ensure equitable access to health care services.
The quantitative articles are authored by Tong et al. (2020) and Mann-Jackson et al. (2018). According to Tong et al. (2020), the purpose of their study is to determine the factors that hinder the interest and willingness to participate in telemedicine among Hispanics, Latinos, and African Americans. The objective of the study is to evaluate patients’ reasons for minimal participation in the clinical trial involving telehealth. The study questions that can be formulated: What are the reasons for the diminished participation of Black and Hispanic patients in the clinical trial involving telehealth? What are the reasons for diminished compliance with the study protocol in the ongoing clinical trial involving telehealth? The article identifies the enablers of not embracing telemedicine are identified. Nursing personnel should be actively involved in patient education on the importance of telemedicine and ensure that it is implemented.
According to Mann-Jackson et al. (2018), the purpose of their research article is to evaluate the experiences of Latino men concerning discrimination, violence, and their legal status as immigrants to access health care services. Two objectives can be formulated from the article. The objective is to determine the impact of discrimination, violence, and legal status on access to health care services. The research question: What measures should be adopted to ensure that Latinos have easy access to affordable healthcare services? This is relevant because nurses should focus on the advocacy for policies that ensure equitable distribution and access to health care services. The advocacy ensures that all Americans, regardless of their racial or ethnic background, have full access to healthcare services that fulfill their needs.
How the Four Articles Support the Nurse Practice Issue
The qualitative and quantitative research articles will be used to answer the PICOT question. Both studies reveal that the ethnic minority population has poor access to healthcare services. Patel et al. (2020) reported that Latinos and Hispanics had little understanding of health care insurance and the Affordable Care Act. On the other hand, Diaz Rios & Chapman-Novakofski (2018) reported that cultural variations, formative work, and decisional balance influenced the participation of Latinos and Hispanics in nutritional research. Both qualitative articles acknowledge that the current (traditional) approaches have created disparities in access to health care services. A policy that takes into consideration the disparities and addresses the people holistically can help to address the problem.
Mann-Jackson et al. (2018) reported that Latinos face discrimination and violence. Furthermore, their legal status in the USA can limit their access to affordable healthcare services. According to Tong et al. (2020), minority African Americans and Hispanics are likely to have limited knowledge about healthcare services. This influences their ability to embrace telemedicine. All stakeholders, including nurses and legislatures, should ensure that favorable policies that promote health equity are adopted.
The authors of the articles used the ethnic minority population as the target group, while the native population was the comparison group. The authors propose different interventions. The etiology of existing discrimination and violence towards the ethnic minority groups should be addressed to ensure equitable access to health care services (Mann- Jackson et al., 2018). Patient factors should be addressed to ensure that telemedicine is fully embraced (Tong et al., 2020). The interventions and comparison group of the articles are harmonious with those of my PICOT question.
Method of Study
The article by Diaz Rios & Chapman-Novakofski (2018) used a longitudinal study design. Longitudinal studies focus on repeated data collection on the target population over a long time. The study by Patel et al. (2020) and Tong et al. (2020) used a cross-sectional study design. Cross-sectional studies focus on data collection at a specific point in time. Mann-Jackson et al. (2018) used a cohort study. Cohort studies aim at data collection over a long timeframe.
According to Thomas (2020), cross-sectional studies have the advantage of timely data collection because they focus on a specific point in time. Their demerit is the inability to establish a cause-effect relationship. Cohort and longitudinal studies can establish a cause-effect relationship because they are conducted over an extended period (Barrett & Noble, 2019). However, they are expensive and time-consuming compared to cross-sectional studies.
Results of the Studies
Diaz Rios & Chapman-Novakofski (2018) identified formative work, cultural variations, and decisional balance as the indicators for participation in community nutrition research. Interpersonal approaches that focus on understanding community settings can help to facilitate participation in these research programs (Diaz Rios & Chapman-Novakofski, 2018). Patel et al. (2020) reported that ethnic minority groups, especially Latinos and Hispanics, demonstrated lower knowledge about health insurance and the Affordable Care Act. Individualized communication approaches are proposed as the intervention to the problem (Patel et al., 2020). The findings of these qualitative articles can be utilized by nurses to formulate a framework for ensuring equity in health care services. They should ensure that a holistic care approach is upheld and that the existing policies benefit the minority groups.
According to Mann-Jackson et al. (2018), approximately 55% of the population reported having experienced unfair treatment when accessing healthcare services. Approximately 41% of the respondents reported racial discrimination and violence to seek health care services. About 44 % of the respondents had been questioned about their legal status. Approximately 56% and 48% reported binge drinking within the past 30 days and 7 days, respectively. Tong et al. (2020) reported that 47% of participants were disinterested in the clinical trial on telehealth. 33% reported inconveniences as the reasons for premature withdrawal from the clinical trial. 13% and 7% reported a lack of beneficial impact and unawareness of their diagnosis, respectively, as the reasons for diminished enrollment and untimely withdrawal from the clinical trial. This information should shift the focus of nursing practice towards the advocacy for policies that ensure equitable distribution and access to health care services. They should ensure that primary health care services and screening programs are intensified to promote timely diagnosis. This enables the ethnic minority to know their health status and seek appropriate care.
Ethical Considerations
Confidentiality and anonymity of the participants and legal approval are examples of ethical considerations (Fleming & Zegwaard, 2018). The four articles upheld the ethical considerations. No names and personal identifiers were used by the researchers. They sought legal approval to conduct the studies. An example is the University of Illinois Institutional Review Board, which approved the study by Diaz Rios & Chapman-Novakofski (2018).
Outcomes Comparison
My PICOT question aims at reducing existing health discrepancies among the ethnic minority population after six months of necessary interventions. The intervention is the adoption of culturally appropriate care-based interventions. The four articles identified the existence of health disparities among this population. Proposed measures to reduce the discrepancies are addressing the etiology of existing discrimination and violence towards the ethnic minority group and addressing individualized patient factors. These findings will be complementary to my intervention toward achieving the desired outcome.
Proposed Evidence-Based Practice Change
The research articles aimed at identifying the existence of disparities in health care services among ethnic minority groups. Furthermore, they identified mitigative strategies for the healthcare disparities. The PICOT question seeks to determine the effectiveness of culturally appropriate care-based interventions. Therefore, the research articles help to identify the best intervention for the PICOT question.
Evidence-based change: adoption of individualized and culturally appropriate care-based interventions. The research articles propose addressing individualized patient factors and the etiology of existing discrimination and violence towards ethnic minority groups. These interventions suggest that policies that advocate for holistic care interventions are important.
Conclusion
Disparities in access to appropriate healthcare services exist among the ethnic minority. The adoption of culturally appropriate care-based interventions, such as addressing the etiology of existing discrimination and violence towards the ethnic minority group and addressing individualized patient factors, can help to mitigate the problem.
References
Barrett D, Noble H. (2019). What are Cohort Studies? Evidence-Based Nursing 2019;22:95-96. http://orcid.org/0000-0003-4308-4219
Diaz Rios, L. K., & Chapman-Novakofski, K. (2018). Latino/Hispanic Participation in Community Nutrition Research: An Interplay of Decisional Balance, Cultural Competency, and Formative Work. Journal of the Academy of Nutrition and Dietetics, 118(9), 1687–1699. https://doi.org/10.1016/j.jand.2018.04.006
Fleming, J., & Zegwaard, K. E. (2018). Methodologies, Methods and Ethical Considerations for Conducting Research in Work-Integrated Learning. International Journal of Work-Integrated Learning, 19(3), 205–213.
Mann-Jackson, L., Song, E. Y., Tanner, A. E., Alonzo, J., Linton, J. M., & Rhodes, S. D. (2018). The Health Impact of Experiences of Discrimination, Violence, and Immigration Enforcement Among Latino Men in a New Settlement State. American Journal of Men’s Health, 12(6), 1937–1947. https://doi.org/10.1177/1557988318785091
Patel, M. R., TerHaar, L., Smith, A., Tariq, M., Worthington, K., Hinton, J., & Lichtenstein, R. (2020). Knowledge of Health Insurance Terms and the Affordable Care Act in Racially and Ethnically Diverse Urban Communities. Journal of Immigrant and Minority Health, 22(3), 456–466. https://doi.org/10.1007/s10903-019-00924-3
Thomas, L. (2020). Cross-Sectional Study | Definitions, Uses & Examples.
https://www.scribbr.com/methodology/cross-sectional study/#:~:text=Longitudinal%20studies%20and%20cross%2Dsectional,an%20extended
%20period%20of%20time.
Tong, T., Myers, A. K., Bissoonauth, A. A., Pekmezaris, R., & Kozikowski, A. (2020). Identifying the Barriers and Perceptions of Non-Hispanic Black and Hispanic/Latino Persons with Uncontrolled Type 2 Diabetes for Participation in a Home Telemonitoring Feasibility Study: A Quantitative Analysis of Those who Declined Participation, Withdrew or were Non-Adherent. Ethnicity and Health, 25(4), 485–494. https://doi.org/10.1080/13557858.2019.1566520
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I have included the first 3 papers for review.
This final paper needs an appropriate thesis that was not expounded upon in the last paper. The paper due this week is titled Document 20.