Describing the Experiences of Guardians and Parents Before and after Transplant Surgery to Children - Term Paper Example

Research and informatics Lecturer A brief synopsis of the study The phenomenon of interest, problem and purpose With an increased number of transplant surgeries, the study main objective was describing the experiences of guardians and parents before and after transplant surgery to children receiving an intestinal transplant surgery in an effort to determine stress levels for the parents and guardians. With little evidence known and published on the Caregiving experiences of children receiving intestinal transplants, the study main aim was to extend the extent of research and provide more evidence. It is important to determine Caregiving experiences before and after surgery to determine levels of stress and other experiences in an effort of developing the appropriate measures of interventions in helping the parents and caregivers cope better during the period of transplant surgery. The focus area of interest The area of focus of the study was determining the parents and caregivers experiences before and after intestinal transplant surgery such as a liver transplant. According to evidence, there is an increased number of transplant surgery and 12,623 transplant surgeries across all ages and organs time were performed in 1988 while in 2010 the number increased to 28, 684. In 1988 out of the total 1,713 liver transplants were performed while, in the period of 2010, 6291 liver transplants were performed. From the surgeries, the children make up 15 percent of the liver transplant surgeries conducted every year. With the survival rate of children undergoing a liver transplant being 91 percent, families end up facing the consequences surrounding the care of the child undergoing transplant surgery. Guardians and parents are challenged in dealing with their critically ill children before and after transplant surgery. With an improved survival rate leading to more transplants, there is need to understand how families cope and experience the transplantation process. Thus, the study main goal was determining these challenges faced by families of children undergoing liver transplants in an effort to determine mitigation interventions of coping during the period. Information for the study will also provide a guide to health care professionals in determining ways of improving the transplantation process. Literature review The literature review of the study is appropriate and adequate covering all dimensions relevant for a research study. Components of a literature review include problem formulation, literature search, evaluation of data and analysis and interpretation of the information (Steward, 2004). The literature review of the research study covers all the area, starting with problem formulation. The research study has explored the relevant material to the subject being explored and as utilized secondary sources in literature search that include books, journals, and articles. The review entails the number of intestinal transplant surgeries conducted annually, to the number of liver transplant surgery conducted, survival rate and incidence of children undergoing liver transplantation surgeries and as well as reviewing other research studies previously conducted on families experience before and after transplantation surgery. The review goes ahead to define stress and posttraumatic stress disorder before and after transplantation surgery its causes and ways of preventing it by reviewing different journals, books and articles relevant to the research topic of study. The literature has been analyzed broadly covering all the major aspects of the study and interpreted accordingly. Thus, the literature review provides a strong support of evidence of the research problem. The reference list is important as it provides the sources that were used in the research study. The reference list for the study is appropriate within the appropriate period and appears at the end of the research study with detailed information about each source that was cited in the study. Method In order to protect the safety of the participants, researchers need to have informed knowledge of the safety of the research to be conducted. If the research is harmful to the participants, the researcher should discontinue the research at any stage or remove participants from the research. No research study should be carried out if it endangers the safety of the participants. Research studies should protect participants from humiliation and discrimination. If harm results to the participants, the researchers need to compensate the participants on the harm acquired (Hueston et al., 2006). Before a research study is conducted, the researchers need to outline to the participants what the research is all about and ask for their consent to taking part in the study. The participants need to be informed of the purpose, procedures, benefits and the length of the study. If the participants are not willing to continue with the study, they should be allowed to withdraw from the study at will. Participants need to be protected from physical and mental harm. This is achieved by applying the ethical principles that include autonomy, beneficence, non-maleficence, justice, respect and ensuring participant confidentiality (Dhai, 2005). The Institutional Review Board (IRB) is mandated with the authority of reviewing as well as monitoring biomedical researchers that entail human subjects. It has the authority of approving, suggesting for modifications or disapproving a research study in an effort of protecting the rights and welfare of the human research subjects (Byerly, 2009). It ensures that the right steps are undertaken in protecting the rights and welfare of participants carrying out a research study. The institutional review board approved the research study accordingly. An informed consent is not a single event or just a form to be signed rather it is a process entailing education that happens between the participant and the researcher. The informed consent should be written in a simple language for easy understanding; the process entails full disclosure of the research nature, adequate comprehension on the part of the participant and the participant’s voluntary choice of participating in the study. The following information needs to be provided what the participant should expect from the study, risks, foreseen, expected benefits, rights of privacy and confidentiality, any compensation to be involved in case of harm and the person the participant should contact if they have any concerns. The research study was involved in mailing letters of invitation with a return form and an envelope for them to indicate their willingness of taking part in the study. This was appropriate in ensuring that only the willing participants would consent to be part of the study. However, it could have been appropriate if the researchers offered further education on the purpose, benefits, importance and risks of the research study by visiting them in their homes to enhance understanding and as more participants could have taken part in the research study. Research design Qualitative design is a systematic subjective approach that is used to describe life experiences and provide them with meaning, unlike the quantitative research design that is a formal objective approach that entails obtaining information on the world. The goals of qualitative research design are to gain insight, explore the depth, richness and the complexity that is inherent in the phenomena as illustrated in the research study analyzed. Qualitative research design is subjective, soft science, entails the individual interpretation and the sample size can be as small as one. The research question is involved in seeking what human experiences and feelings indicating the concern of phenomena, as well as the necessary and sufficient constituents of the experience (Silva, 2008). The methodology is involved in seeking individuals who understand the study and are willing to participate to express their experiences and feelings and data collection method involves interviews, observation, and audio or video tape (archival content). Researchers describe the findings from their subjective point of view, identify themes are involved in coding and transcribing. The research study used a qualitative approach with an aim of capturing the individual guardians perceptions of their experiences preparing for and providing care to a child after transplant surgery. Thus, its main aim was gaining insight into the guardians and parents perceptions and experiences who cared for a child who underwent transplantation surgery, explore and gain complexity of the phenomena. A small sample size was involved in the study as only a few participants consented to the study. The research questions involved seeking human experiences and their feeling towards their children who had undergone a transplantation surgery. The parents’ interviews were recorded, transcribed verbatim and verified for accuracy. The research team identified themes and four nurse experts were involved in transcription. As well, various strategies to ensure the rigor of qualitative research were integrated with the teamwork. Thus, the research design was congruent with the qualitative research design. Population and sample The population for the research study involved guardians and parents of children who were organ transplant recipients to determine their experiences and perceptions before and after surgery. Participants taking part in the study involved all the English-speaking parents and guardians of children who had received intestinal transplantation between the period of 2000 and 2008 at the facility and had returned home and died were invited in the study. The population was purposely chosen so that other participants could be sampled in the next research phases. The exclusion criteria included guardians and parents who were not English speaking or whose child was dismissed for terminal care. Interviews were used and did not focus on the child’s death, as death was not the anticipated outcome upon the child’s dismissal from the hospital. 6 participants gave consent, but only five interviews were successfully completed. Saturation is the point in the collection of information in a research study where no relevant or new information emerges with respect to the purpose of the study (Kitto, Chesters, & Grbich, 2008). When the aim of the research appears to be robust with no gaps and unexplained phenomena’s, then the point of saturation of the research has been attained. The saturation point is naturally occurring and the research will know when it is reached if no new information no longer emerges. Factors that influence saturation entail the size of the sample, the inclusion criteria for the sample and the quality of the data collection techniques. Data collection and measurement According to Houser, in the data collection and measurement methods, qualitative data is not easy and quick to handle. A mistake that is usually made by many researchers is reducing quantitative data to symbolic-numeric representations and quantitatively computerizing them. Data collection method involves interviews, observation and audio or videotape (archival content). Interviews include conducting one on one interview or group interviews. This information can be recorded in a variety of ways that entail video recording, audio recording, written notes and stenography (Marshall & Rossman, 1995). The purpose of an interview is to probe the ideas of the participants about a certain phenomenon of interest. Measurement entail seeking the human experiences and feelings indicating the concern of the phenomena. The research study utilized interviews for data collections and the interviews were recorded into video tapes. The participant’s experiences and feeling were grouped into three areas of focus that is interaction with the transplant team, interactions with the local health care system and a response on perceptions of caring for themselves and their child. Results Qualitative data analysis is a range of processes where information is moved from qualitative data into the form of explanation, interpretation or understanding. The process entails writing and themes identification. However not all the approaches will require the identification of themes. Coding of themes then follows. This entails the identification of information and applying labels that illustrate that there are examples of some thematic idea. Coding enables the researcher to quickly retrieve and collect information that is associated with a particular thematic idea. This makes it essay to examine the information together and different cases can be compared in that respect (Silva, 2008). Other methods include recursive abstraction where datasets are summarized and the summaries are further furthered to summaries. This result of the method is a compact summary that could have been difficult to attain. Correct procedures for qualitative data analyzes were conducted in the study as data was coded and themes were formulated aiding in the analysis of the information. A key issue of qualitative research study is the establishment of trustworthiness also referred to as dependency or credibility of the research study. Trustworthiness is crucial as it helps in supporting the argument of inquiry (Sambunjak, Straus, & Marusic, 2010). In ensuring trustworthiness in the research, the transcribed interviews were read toughly for researchers to become familiar with them and this way the researcher comprehended the information. Thus, justification from a different researcher in data analyzes was essential in reducing researcher bias. Other measures of ensuring validity entailed maintenance of an audit trail, searching for negative evidence, as well as the maintenance of open communication among the researchers. Triangulation is a process that entails the utilization of more than one method of data collection on the same research. This helps in assuring the research validity through the utilization of a variety of methods for data collection on the similar topic that may entail different types of samples (Jackson, Drummond, & Camara, 2007). A single data collection method or a sample can never adequately shed light on a phenomenon thus different multiple methods can help in facilitating deeper understanding. It main purpose is not necessary cross-validating information but helps in capturing different dimensions on a similar phenomenon. Triangulation was utilized in the research study as the researcher invited participants whose children had died after transplantation surgery. Thus in getting a deeper understanding of the study area, the researcher involve guardians and parents whose children had died and those whose children survived after surgery. Findings According to the study results, the experiences of the guardians and the parents indicate that it is important to improve communications, relationships and other processes between them and health care providers during and after transplantation surgery. This is important to be able to address the parental levels of stress as well as improving the quality of care provision for the families and the children. There is a need for the guardians and parents to be the central focus of rounds and directly care for the patients and the family. Ensuring that all the questions asked are answered is important and that the family should not feel rushed when they try to voice their concerns, questions and thoughts. When the patients get well, the discharge information needs to be communicated in the best possible ways suited to the learning styles of the parents and the guardians. This is important in developing a supportive environment and a trusting relationship. The transplant needs to build a positive relationship with the family by making sure that they meet the needs of the families. Lack of a good relationship results to stress and it can predispose the patient to further complications such as the post-traumatic stress disorder. As well, the long-term nature of the transplantation process and medical care after the transplant surgery can worsen and prolong the levels of stress. Tables were used to illustrate the study finding and they were easy to read and interpret. Discussion The research finding of the study are strong and it recommends for other studies to focus on focus on effective communication and ways of building relationships between families and the transplant team to enhance quality care delivery. The study is relevant for clinical practice and further research.it contributes positively to the nursing practice as it adds to the body of literature on the experiences of guardians and parents before and after their children transplantation surgery. It supports the need to continue further research regarding the methods of improving better care to parents and guardians of transplantation patients. It provides for better ways of care and handling the guardians and families following surgery to reduce stress levels and other complications bound to arise. Furthermore, the study results will contribute to future studies that will build on the findings of the study. References Byerly, W. G. (2009). Working with the institutional review board. American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists, 66, 176–184. doi:10.2146/ajhp070066 Dhai, A. (2005). Research ethics review--protecting participants in research. South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde, 95, 595–597. Hueston, W. J., Mainous, A. G., Weiss, B. D., Macaulay, A. C., Hickner, J., & Sherwood, R. A. (2006). Protecting participants in family medicine research: A consensus statement on improving research integrity and participants’ safety in educational research, community-based participatory research, and practice network research. In Family Medicine (Vol. 38, pp. 116–120). Jackson, R. L., Drummond, D. K., & Camara, S. (2007). What Is Qualitative Research? Qualitative Research Reports in Communication. doi:10.1080/17459430701617879 Kitto, S. C., Chesters, J., & Grbich, C. (2008). Quality in qualitative research. The Medical Journal of Australia, 188, 243–246. doi:10.1177/107780049900500402 Marshall, C., & Rossman, G. B. (1995). Data Collection Methods. In Designing qualitative research (pp. 97–150). doi:10.3390/s110707188 Sambunjak, D., Straus, S. E., & Marusic, A. (2010). A systematic review of qualitative research on the meaning and characteristics of mentoring in academic medicine. Journal of General Internal Medicine. doi:10.1007/s11606-009-1165-8 Silva, C. N. (2008). Designing Qualitative Research. Forum Qualitative Sozialforschung/Forum: Qualitative Social Research, 9. doi:10.1057/omj.2011.23 Steward, B. (2004). Writing a literature review. British Journal of Occupational Therapy. doi:10.1362/1469347002529189 Read More