Qualitative Research Critique

Proot, I. M., Abu‐Saad, H. H., Crebolder, H. F., Goldsteen, M., Luker, K. A., & Widdershoven, G. A. (2003). Vulnerability of family caregivers in terminal palliative care at home; balancing between burden and capacity. Scandinavian journal of caring sciences17(2), 113-121.

Background of the Study

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The paper involved a qualitative research that was conducted through a grounded theory interview-based study to establish the vulnerability of the family caregivers in terminal palliative care. The aim of the study was to explore the experiences of the family caregivers, their needs at homecare, and the health services that they received. The study is indicating to have been part of a large-scale research project that aimed at establishing how to offer a good death to the patients by providing palliative care at home. The article is indicated to have explored the experiences that the family care giver had at home in giving care to a terminally ill person of the family. The article does not explicitly indicate the research questions and the purpose. 

Method

The method used in the research was grounded theory of the qualitative research design to explore the needs and experiences of family members in taking care of a terminally ill person at home. The study was carried out through interviews with family members of the terminally ill patients who had a life expectancy of less than 3 months.  The research identified the need of using a grounded-theory for this study which exemplifies its importance. Ground theory is said deal with descriptions and perceptions of the respondents and respondents engaged in the study. For this reason, the researcher indicated that the concepts would not be gained from the literature. For that case, very few references have been used in the literature review. The researcher has used about five references as part of the literature review with most of these being qualitative studies. The oldest reference used is dated 1990 and which is qualitative in nature and thus can be relied upon. 

Results of the Study

From the study, the researchers were able to acquire factors that could be associated with vulnerability. These factors were classified into the decreasing factors or the increasing factors. The family members were found to get fatigue and burnout in the course of giving care to the terminally person. The situation was found to make the family caregiver vulnerable not withstanding their courage and strength. They indicated the need to attain balance in offering the care. The vulnerability increasing factors found through the study included care burden, restriction in activities, fear, insecurity, loneliness, facing death, and lack of support. The vulnerability decreasing factors found to include continuous previous activities, hope, keeping in control, satisfaction, and good support. 

The results of the study had implications to the nursing as it highlighted the factors where the family care givers might require assistant on to ensure that they continue offers the best care to the patient. The nursing professions in the discussion were found no to be sensitive enough to the role of the family in palliative care. This implies that the study presented a wake-up call for the nursing staff to enhance their collaboration with the family caregivers. The role of the professional healthcare staff was considered to be instrumental to the family care givers n terms of giving them emotional and psychological support. Being ignorant of the needs of the family members palliative care was noted that it could cause the inadequate provision of care, it for this reason that the health care professional is called upon to increase their awareness that the family care givers are an important object of the care and support.

The study contributed to knowledge to the nursing world by highlighting the plight of the family care givers who are important element of palliative care but have for long been ignored with their needs disregarded. The study indicated the vulnerable position that these family care givers are in and how badly they needed the attention of the professionals operating in the terminal home care. The research added into the research knowledge by providing more information on vulnerability. Vulnerability has been indicated as being different from being powerless. The family members are said to be vulnerable due to the important role that they play in the care of the terminally ill patient. Vulnerability was indicated not as the direct opposite of autonomous but found to go hand in hand. The study pointed to the significance of the family care givers being cognizant of the need of care as well as being aware of the accompanying vulnerability. This knowledge is important in impact the planning for palliative care for patients with terminal illness as the patients would be included in the planning stages to ensure that the risk of burnout and fatigue is addressed at an early stage. The study was also relevant in pointing other relevant areas where more work was required especially in educating and training the professional on how to handle the vulnerable positions of the families caring for the terminally ill patients. It also indicates the need to identify the family members engaged in offering the care and search for ways to actively engage them. 

Ethical consideration

 The article does not offer a clear picture on how they handled the ethical issue involved in this nature of research. However, the article notes that part of the interview procedure included tape-recording the interview session and later transcribing them. On this note, it is indicated that the recording was only done after the interviewee granted the consent. This indicates that the participants were made aware of their rights of being recorded which is one key component of the ethical standards required in an interview. The article does not indicate whether the participants were made aware of the ethical obligation that was crucial to such a research including need for confidentiality. 

Conclusion

The study indicate vulnerability among the care givers of patients with terminal illness ads crucial in attaining a balance between the care burden and capacity of the caregivers to cope. This was an echo to the thesis statement that had indicated the aim of the study as seeking to establish the balance between the burden and capacity by exploring the experiences of the family care givers. The experiences discussed in the study was important pointer to the health profession on the need to engaged the family members in the palliative care.

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