Fatigue and Sleep Disturbance in HIV-Positive Women by M J Simoni et al - Article Example

Article critique Name Institution Instructor Course Date of Submission Article Critique The biodemal and behavioral expertise in nursing is greatly needed in the HIV/AIDS patients. According to the report, there has been no empirical data on this yet. There are very few studies that have examined the relationship between HIV and sleep disturbances. In patients of any kind, fatigue and sleep disturbance are quite common. This may be caused by a number of factors related to the illness. Stress caused by pain and the fear of the outcomes of the illness are very common. Stress on the other hand leads to lack of sleep and lack of sleep causes fatigue (Scott-Sheldon, 2008). The article explores how energy levels are affected in women diagnosed with HIV/AIDS in china. The clear and comprehensive abstract helps the reader to capture the whole idea of the report on the first page. It explains each stage briefly yet conclusively. In the introduction, the author acknowledges that there have been various studies on fatigue in HIV/AIDS patients but asserts that a combination between biodemal and behavioral expertise conspicuously lacks. The author provides these as the justification of the study. The justification is appealing as it is hard to establish a comprehensive solution while dealing with two aspects independently. The literature captures the figures of women with HIV/AIDS particularly in china, suggesting that they are the most affected compared to men. With an appropriate citation, the authors of the article should be commended on the use of various research documents to compare literature in the background section. Various studies and up to date documents are assessed, convincingly explaining sleep disturbances and fatigue in patients with HIV/AIDS. In addition the literature explains that psychological stress is apparently behind the lack of sleep which in turn causes a lot of fatigue during normal day functioning. In addition, the background part of the report is strengthened by the fact that there is apparently a lot of literature captured around the topic of study. For instance, the article explains how the fatigued patients of HIV are highly vulnerable to the negative consequences of the disease. Here, the article explains that women with HIV experience more fatigue than men with HIV. This then implies than women are more vulnerable to the disease than men. Even though evidence on why fatigue is common in women than men is not captured, the article successfully justifies the need to perform this research on women other than men (Scott-Sheldon, 2008). The article, explains that there are hitherto few studies specifically focusing on the sleep disturbances and fatigue among the HIV population in China regardless of the fact that this problems exist. The Chinese culture apparently discourages complaining of common problems such as sleeplessness and fatigue. This cultural disposition justifies a research on more specific to the Chinese context. In addition, the article as much as stress affects the sleeping patterns of the general population, the article justifies the study by arguing that there is lack of empirical data on the same relationship across the HIV/AIDS population. As much as this stand is convincing, it seems quite contradicting there is evidence in the literature part showing that stress and fatigue are common in HIV patients. This implies that this data is not entirely lacking. Using actigraphy devices, the study assumes a qualitative methodology. The article explains that the researcher used only participants who were willing to volunteer. Apart from the fact that this is ethical, it increases the credibility of the information as volunteers tend to be open. The code of research ethics was further upheld by the fact that the researchers recorded the interviews with prior consent of the participants. From the evidence in the article, the interviewers merely prompted the participants with questions and allowed them to lead the discussion. This disallows the over direction by the interviewer which may lead to biased data collection. In addition, the interview was conducted in native language with a Mandarine native speaker. This is also credible as it ensures it implies that the participants were comfortable with the language. However, it should be noted that this was a disadvantage on the other hand as important information is often lost during translation. The study used snowball ball sampling methods but the article does not explain why this method was preferred. In addition, the article does not explain why the qualitative methodology was considered most appropriate. About 19 participants were sampled mostly from shanghai with only one from outside the region. However, there is no explanation in the study that justifies this number or explains why the study mainly concentrated in Shanghai. The explanation on whether the data can be generalized to cover the whole of china or whether there could be different results from samples in other regions is also omitted. This information is necessary for readers need to be guided on the range within which the results of the study should be interpreted. Use of two bilingual researchers particularly in doing comparisons while translating the data in the aim of reducing data loss during translation is however, commendable (Simoni, 2010). From the article, participants in the study provide varying amounts of fatigue and sleeplessness resulting from worry, nightmares and the fear of transmitting it to their loved ones. The mean age of the participants’ is stated as 42 and it is explained that most of this participants’ had migrated to Shanghai after they had been diagnosed with the disease. The article tabulates the demographics of the nine participants who accepted to ware artigraph watches clearly in the in the results section rather methodology section under sampling (Bailey, 2003). The study revisits the literature section and highlights other views around the topic before presenting the results. According to the results presented, many of the women started experiencing sleepless nights and fatigue after they were diagnosed with HIV. The study however conspicuously omits mentioning the exact number or the percentage. This information is quite vital as the reader is not supposed to guess the extent referred to as many. The study is however strengthened by the fact that the researchers provided samples of recorded responses in the article for any reader to make an evaluation from the participants first hand response. However, as explained earlier, these samples are a product of a translation in which vital information may be lost during the process. In addition, it is hard to evaluate the influence of the translators in the final results of the translation. According to the results, there are different factors that contribute to sleeplessness among the HIV women. For instance, some suffer from perpetual regrets while others fear to infect their partners. This also includes the side effects of the medicine given to the patients. The resulting consequences include fatigue during the normal functioning of the day. From other studies, any other overwhelming problem that can stress of depression my lead such results (Simoni, 2010). In this case, the study does not explain how unique these results are to HIV patients particularly women. The results from an act watch monitor are more objective and are compared with diary entry for three days to improve on the accuracy of the data. They are clearly tabulated indicating results for each of the nine participants. From these results, women who longer diagnosed with HIV had more sleep. The table does not however represent the sleep patterns at all stages. This is excused on the big size of the sample. The reader thereby has to base on the researchers generalized perception to assume the entire distribution of the sleep patterns. The analysis part highlights a few weaknesses of the study, among them is the limitation of the sample study only to Shanghai group which is a metropolitan region influenced greatly by the western cultural attitudes and explains thereby the results should not be generalized to all women with HIV in china. In addition, only nine participants wore the wrist antigraphy devices which are less than a half of the number sampled. The article also explains limitations in the antigraphic data due to lack of prolonged monitoring which could increase internal validity and proposes this in the next studies (Bailey, 2003). In addition, the analysis part of the article explains that none of the patients mentioned stress or depression which may have been a function of cultural conventions. In the study sleep disturbances and fatigue were evident among Chinese women with HIV. This was attributed to restlessness and insomnia apparently attributed to the stigmatization associated with the disease. The discussion section is detailed and clear and consistently compares the results with the reviewed literature. However, the analysis seems biased towards the aim of the study and fails to compare the results with other factors in the common population. The study concludes that the sleeplessness was caused by stress. This asserts that women have different things expected of them than men. It should assertion is merely mentioned in the literature review and is not in the findings section. According to the course of the study this is far from the aim of the study. Apart from giving a strong conclusion that justifies the aim of the study and confirms the hypothesis, which is not even clearly stated, the report, in the conclusion section, fails summarize the main parts of the study including the strengths and the limitations. The recommendation part is a brief, single sentence submerged in the introduction. It also explains that the women lacked refreshing nocturnal sleep and recommends a culturally accepted intervention that helps them improve their sleeping patterns. Being the first of its kind done on this topic in china, the report is credible in most of its sections. The varied literature review provides the reader with a great insight into the topic. The abstract on the other hand provides a clear and comprehensive summary of the report of the report. However, the article has great limitations particularly in justifying the methodology and presenting the results. In addition, it does not provide a rationale for the chosen sample which may cost pose problems to any other study that would want o base on it. In general, it is an appealing report that should prompt more research on this topic. References Bailey, D et al (2003) Practice parameters for the role of actigraphy in the study of sleep and circadian rhythms: An update for2002.Sleep26, 337–341. Penza k SR, Reddy YS & Grimsley S, R. (2000) Depression in patients with HIV infection. American Journal of Health-System Pharmacy57, 376–386 Scott-Sheldon L. A. (2008) Stress management interventions for HIV adults: a meta-analysis of randomized controlled trial.HealthPsychology27, 129–139. Simoni, M. J et al (2010). Fatigue and sleep disturbance in HIV-positive women: a qualitative and biomedical approach. Journal of Clinical Nursing, 22, 1262–1269 Read More