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The article, “Timing of preoperative patient teaching” by Lepczyk, Hunt, and Rowley is a research paper that seeks to investigate the effects of timing of preoperative patient teaching on pre admission and post admission anxiety as well as knowledge levels.
The researchers start by justifying the purpose of the research. This justification lies in the fact that nurses need to come up with strategies to introduce cost effective preoperative teaching programs before introducing the hypothesis of their study.
The hypothesis assumes that if nurses give preoperative teaching at a time prior to admission to cardiac patients, the patients will experience less preoperative anxiety and have higher knowledge level as compared to those receiving preoperative teaching after admission. The article explains how the researchers proceeded with the subject matter under study.
The researchers subjected three samples of patients from two different hospitals to different conditions before subjecting the first group to pre admission preoperative teaching, the second one to post admission preoperative teaching and the last group to no preoperative teaching to act as a control of the study.
This article is based on nursing theory because the subject matter of the research directly touches on the role of nurses as parties charged with the responsibility of health care, which include preparing patients for a cardiac operation. The conceptual model used is related to nursing research because it involves study of the behavior of patients as a response to teaching administered to them (patients).
The article identifies the major concepts of the model and defines them well. The concepts that I think it identifies include; it uses three sample groups among which the third acts as a control; It subjects the first two groups to different conditions (pre admission and post admission teaching), and applies exclusion of patients whose response would not be based on what the researchers anticipated.
I solemnly think that the theory used does not have sufficient details because of its failure to satisfy the hypothesis for anxiety. The fact that patients from both groups had comparable anxiety levels instead of prior admission of patients experiencing less anxiety underscores my views. In addition, the response the article gives concerning this issue is more assumptive than factual.
This design is of a questionnaire type given the approach it adopts in collecting information from the patients. According to the article’s contents of table, two questions seek to establish prior knowledge that a patient has regarding heart diseases and surgery. This qualifies the design to be a questionnaire.
The research question seeks to establish whether pre admission teaching of cancer patients would result in them having less anxiety and more knowledge than post admission ones. It is important to answer this question because only then, one can know whether the findings truly satisfy the hypothesis or not.
The threats to internal validity include presence of patients lacking fluency in written English hence hindering information gathering and presence of those requiring other surgery besides by-pass surgery hence calling for different or more pre admission teaching than others.
The threats to external validity include presence of patients requiring emergency surgery and former patients of heart surgery. Patients in both categories do not need pre admission teaching. In order to control this phenomenon, the researchers excluded the above four categories of patients from their study sample.
The sampling used for the study is the random type for the researchers selected patients as they arrived in two different hospitals without adhering to a laid down procedure. This was the most appropriate sampling technique to use because it does not have elements of biasness. The article has described the sample characteristics well. The researchers divided the sample into three groups.
The characteristic feature of the first sample was heart surgery patients subjected to pre admission teaching. The second group comprised of heart surgery patients subjected to post admission teaching while the third group which acted as a control incorporated patients who had not undergone either pre admission or post admission teaching.
The researchers identified limitations to generalizability; an element comes out vividly when one considers the general assumption the researchers considered, that surgeons did not give patients information about their conditions and as such, they only had knowledge they received during pre admission and post admission teaching.
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This resulted in both groups of patients having comparable levels of anxiety, an outcome the researchers did not anticipate. The article has mentioned some elements of attrition. Finally, there are earlier researches in the same field that have produced differing results. The researchers of this article did not employ any strategies of retention or recruitment.
“Timing of preoperative patient teaching” is a good attempt towards explaining the relationship between time of administering teaching to a patient and his/her anxiety and knowledge level just before an operation.
This article is however limited in the manner in which it handles theory of the subject matter. The premature assumption it makes about transfer of knowledge by surgeons to their patients leads to unexpected results that do not confirm what the hypothesis stated.
Lepczyk, M., Hunt, E., & Rowley, C. (1990). “Timing of preoperative patient teaching”. Journal of Advanced Nursing, 15, 300-306.