Larval Therapy Using a Standard Debridement Method Essay

Introduction

Credibility of any research paper depends on the methods of data collection and analysis used. Nurses use a number of research methods to gather and analyse information about varied illnesses in the nursing field. One of the research methods that the nurses use commonly is quantitative research. Nurses identify different variables and collect data to determine the correlation between the variables (Burns & Grove 1997).

The data is normally in numerical form and it is analysed using statistical methods. This paper will critically analyse a research paper conducted to determine the clinical efficacy of larval therapy using a standard debridement method. The paper will analyse the study design used by the pollsters. It will then analyse the sampling techniques used for the research as well as the method of data collection applied. Furthermore, the paper will critique reliability and validity of the study tools used. Besides, it will identify any bias that is manifested in the research.

Importance of the topic

Nurses encounter challenges when serving patients suffering from different illnesses. One of the challenges occurs when treating patients suffering from venous leg ulcers, which lead to patients suffering from chronic lesions. Nurses use various approaches to treat these patients; however, the majority of the approaches do not help to achieve a lasting solution (Burns & Grove 1997). The wounds keep on relapsing.

Hence, nurses are looking for a therapy that will help to address this problem. Larval therapy is one of the treatment procedures that nurses are currently using to treat venous leg ulcers. This topic is critical to the nursing field as it will help to determine the relevant method of analysis to use when analysing data concerning challenges facing the patients. Besides, the topic will help nurses to gain experience in how to develop a research design, hence ensuring that they conduct a comprehensive and unbiased research.

Importance of research in nursing

Nursing research entails a comprehensive approach and perceives the cure of the sick, caregivers, and family members as a whole. Research helps to come up with healing methods that cover the entire community that partakes in taking care of the sick. Therefore, it not only helps to alleviate suffering but also nurtures a healthy community. In addition, research helps nurses to evaluate the need for actions, hence intervening before a health problem arises (Hootman 2002).

Besides, it helps the nurses to foresee possible results of particular nursing decisions. Consequently, research aids nurses to avert possible dangers by making sure that they are prepared for any eventuality in the course of their activities. Presently, the nursing field suffers from an escalation in costs associated with health care. Research will help nurses to come up with cost-containment procedures aimed at cutting down on operations cost in the field. Through research, nurses can now avoid unsafe and trial-and-error interventions, which add to the operations cost in the nursing field (Hootman 2002).

Research is a critical component in the nursing field. One of the benefits of research in nursing industry is that it promotes innovation. Research helps nurses to come up with novel body of knowledge, which assists to enhance their services. The palliative care that nurses give to patients suffering from terminal illnesses came as a result of research. Today, nurses are able to alleviate human suffering, thanks to research (Hootman 2002). Research helps to promote professional accountability.

Nurses require making critical decisions based on empirical evidences. Therefore, integration of research substantiation into decision making processes in the nursing field promotes accountability. Before a nurse decides the relevant treatment approach to use, he or she ought to have ideas about the repercussions of the approach. This can only be made possible through research (Hootman 2002).

Nursing research aims at “developing and promoting high levels of standards in the following areas: high quality management of patients during long term illnesses, developing advancements, which aid patients in recovery, and developing standards that help to reduce the number of diseases” (Hootman 2002, p. 18). Research aids nurses to identify the shortcomings in their daily operations. Hence, it assists to increase their skills and competencies in the nursing career.

Currently, nurses, through the help of scientists, have come up with novel methods of treating HIV/AIDS patients. Research has helped nurses to come up with “high-impact HIV prevention approaches” (Hootman 2002, p. 21). In addition, nurses have come up with Test-and-treat programs that are based on the assumption that they require coming up with methods of diagnosing and treating individuals living with HIV/AIDS to control infection. This has led to changes in the initial approach, which used the CD4 cell count to determine the appropriate treatment to give to a patient suffering from HIV/AIDS.

Key words

Some of the key words used in this research include validity, reliability, and debridement. Validity refers to the capacity of the study tools to assess the expected variables. Reliability refers to the capacity of the study tools to assess the idea under research precisely and constantly. Debridement refers to “the surgical exclusion of dead tissues from a wound to accelerate healing and control infection” (Burns & Grove 1997, p. 113).

Research design

Research design stands for the organization of a research study. In other words, research design focuses on issues like research subjects, variables, research schedule, and procedure. Pollsters use varied research design based on the data that is required. Quantitative research uses numerous research designs, which include correlation studies, experiments, and surveys (Tanner 2003). In investigating the clinical efficacy of larval therapy, pollsters used randomised controlled trial to collect information. This was the most suitable research design for the study. Randomised controlled trial helps researchers to determine the cause-and-effect correlations between various variables.

Through the research design, pollsters are able to stage-manage different research variables (Tanner 2003). Besides, researchers are able to allocate the participants to different groups randomly, thus giving each participant equal chance of partaking in the study. Through the design, pollsters were able to allocate the participants to loose larvae, bagged larvae, and hydrogel. This gave them an opportunity to determine how the different participants responded to different treatment methods.

It would have been hard for the pollsters to conduct numerous tests using a single research without randomised control trial. Furthermore, the study design gave pollsters the opportunity to set aside a group of participants to use as the comparison group. Consequently, by using randomised controlled trial researchers were able to get substantial information concerning larval therapy.

The randomisation process utilised a computer program, which generated arbitrary permuted blocks and assigned the participants to each block on a random basis. This helped to avoid chances of allocating individuals exhibiting similar symptoms to the same block, thus enhancing the quality of the results. To get good results, pollsters ought to make sure that they do not study two or more populations at once (Tanner 2003).

Randomised controlled trials help pollsters to select participants who do not have confounding variables. This underlines the reasons why pollsters did away with lactating and pregnant patients. The major drawback of using randomised controlled trial is that researchers lose track of the treatment procedure easily. In the course of the study, nurses may not be able to monitor all the participants, and this affects the final results. This highlights the reason why pollsters conducting the larval therapy exercise requested some of the participants to complete a questionnaire that sought to determine the effectiveness of the therapy.

Sampling

Polit and Beck allege, “The degree to which a sample reflects the population it was drawn from is known as representativeness. In qualitative research, this is a decisive factor in determining the adequacy of a study” (2006, p. 17). Pollsters ought to use a probability sample when conducting a study. Failure to use a probability sample leads to results that are hard to generalize and apply for a certain target population (Parahoo 2006). Moreover, the sample size is also critical in quantitative research as “small samples are at risk of being overly representative of small subgroups within the target population (Parahoo 2006, p. 34).

Sampling error increases with decrease in sample size (Burns & Grove 1997). In this study, researchers were clear about the target population. Besides, they identified the criteria used to select the participants. Hence, the criteria used to select the participants were free of ambiguity, and they made sure that individuals with confounding variables were excluded from the study. Besides demonstrating how the sample was selected, the researchers also indicated the number of people who were requested to participate in the study. This helps to determine if there were biases in the selection process and if the sample size was suitable for the target population.

In investigating the effectiveness of larval therapy in treating venous ulcers, pollsters invited 1712 participants to partake in the study. However, the pollsters only selected 267 participants out of the total. This number of participants is too small relative to the population that suffers from venous ulcers. Besides, to determine the effectiveness of using various treatment approaches, the participants were split into different groups.

Hence, the sample size undermined the quality of final results. As many people suffer from venous ulcers, it was imperative that pollsters use a bigger sample size for the study. Conventionally, quantitative research requires a bigger sample size (Russell 2005). Researches conducted in the nursing field play a significant role in the enhancement of health services. Hence, the researches ought to yield accurate and comprehensive results. To achieve this, researchers must ensure that they use a sample size that represents the entire population with respect to gender, age, and other critical factors.

The sample used to investigate the effectiveness of larval therapy represented the entire population effectively with respect to gender. In spite of the sample size being small, the study catered for both genders. Besides, participants were selected using different factors like the size of the lesion, if the participant is suckling or pregnant, and if the participant is using anticoagulants. These factors were crucial in ensuring that pollsters did not come up with a sample that comprises of two populations. Nevertheless, they led to many patients being locked out of the study. All the participants selected shared common features.

Data collection

Polit and Beck allege, “The next factor to consider after establishing a research design is the method of data collection to apply in the study” (2006, p. 46). Quantitative study allows the use of different methods of data collection. Among the methods used include, interviews, attitude scales, questionnaires, and observational tools (Polit & Beck 2006). Researchers ought to evaluate all the data collection methods with respect to validity and reliability (Lindsay 2007). In the research about the efficacy of larval therapy in curing venous ulcers, the researchers used questionnaires, observation, and photography to collect information.

Consequently, nurses were able to gather vital information for the study by observing how the participants responded to the different therapeutic approaches. Besides, the method of data collection gave them an opportunity to interact with participants and inquire on other information, which is hard to collect using other methods. The major limitation of this method of data collection is that it was hard for the nurses to study attitudes. Moreover, it was hard for the nurses to study past events through observation. They had to use a questionnaire to inquire on past events to be able to help patients. Observation requires time. Consequently, the nurses had to bear the burden of monitoring the participants for a long time before recording any remarkable change.

Apart from observation, nurses took photographs of the lesion to help in assessing patients’ progress throughout the therapy. The photographs assisted nurses to determine if the participants made any substantial progress. Besides, photographs helped the nurses to determine which therapeutic approach was effective in dealing with venous ulcers. Nevertheless, photographs are subject to viewers personal construal (Russell 2005). Consequently, this method was vulnerable to biases as nurses sought to support their preferred therapeutic approach.

Nurses also used questionnaires to gather information concerning use of resources and quality of life. This method of data collection was important for the study since it made it possible for researchers to use statistical methods of data analysis. Besides, the use of questionnaires gave the nurses an opportunity to analyse the data objectively and scientifically. Nonetheless, it was hard for the nurses to collect information that concerns changes of feelings, behaviour and emotions, which is critical in coming up with curative measures. Besides, questionnaires led to collection of subjective information. Consequently, it was hard for the nurses to ascertain if information collected through questionnaires were a true reflection of what the participants experienced.

Study tools

After making out the right method of data collection to use in the study, pollsters ought to design the research tools. Burns and Grove posit, “Researchers have the choice of using a previously designed instrument or developing one for the study and this choice should be clearly declared for the reader” (1997, p. 56). If researchers opt to use previously designed tools, they have to guarantee that the tools will help to achieve the required results. They can do this by describing how the selected tool has measured the theories under research. One of the previously designed tools is in the form of standard scale, which is used to measures certain views, attitudes, opinions, perceptions, or abilities.

Nurses used a visual analogue scale to record ulcer-related pain. However, they did not clearly state if they came up with the scale or they used a previously developed scale. Consequently, it is hard for one to determine the validity and/or reliability of this tool since one does not understand how it operates. Apart from the scale, the researchers also used SF-12 as the other study tool. The tool was formerly found to be responsive to the healing process of venous ulcers. Hence, the tool was reliable and valid in determining the healing process of the different curative procedures since it had been tested before.

The study tool helped to measure the participant’s discernments of quality of life. Wood, Ross-Kerr and Brink (2006) suggest that researchers need to include a section, which describes the validity and reliability of the study tools. However, in the study about the effectiveness of larval therapy in treating venous ulcers, the section was conspicuously absent. Nevertheless, one can evaluate the validity and reliability of the study tools used through focusing on the data that each tool intended to collect and the results of the study. For instance, the questionnaire used to collect information concerning the use of resources and quality of life was reliable as evidenced by the data collected.

Statistic

Researchers used SAS version 9.1 to test the efficacy of larval remedy in curing ulcers. The two sided 5% confidence interval used in the study helped the researchers to minimize the chances of making significant error during data analysis. The log rank test used to compare the debridement period for the different therapies gave room for the researchers to track the precision of their research model.

The use of descriptive statistics helped researchers to analyse non-numerical data collected during the study. Besides, regression model helped the researchers to analyse the changes in bacterial weight in the different therapies. Fisher’s exact test played a significant role in testing the proportion of Methicillin-resistant Staphylococcus aureus (MRSA) in the participants. This helped the researchers to determine the effects of bacteria on venous ulcers.

Bias evident in the study

In quantitative research, biases occur in different forms. The biases may result from research design, procedure, sampling, and selection of the topic of study (Valente 2003). One of the biases that arose in the study about the effectiveness of larval therapy in treating venous ulcers was as a result of sampling method used. Randomised control trial made it hard for researchers to obtain a sufficient number of participants. The nurses made an assumption that few people suffered from leg ulcers.

Besides, the absence of many patients with sloughy ulcers led to nurses assuming that few people suffered from leg ulcers. Consequently, this assumption led to nurses using a small number of participants and excluding many who could have been of great help to the study. Indeed, it was hard for the nurses to recommend regular use of larval therapy to treat patients with sloughy leg ulcers since they did not include these patients in the study.

The selection of topic of study was also biased. In spite of this being the first research about larval therapy, the researchers chose to investigate the correlation between larval therapy and total bacterial weight only. Consequently, one cannot use the findings of this study to make a verdict about the effect of larval therapy on other genus.

Ethics

Beauchamp and Childress identify “autonomy, non-maleficence, beneficence and justice as the four fundamental moral principles” (2001, p. 23). According to Beauchamp and Childress (2001), every person has the right to decide to partake in an investigative study without being intimidated. In the study about the effectiveness of larval therapy, pollsters made sure that all participants agreed to take part in the study without compulsion. This led to the participants sharing their experience without malice. Besides, researchers made sure that participants were aware of what the research entailed. Consequently, the participants we ready to allow the pollsters to collect even sensitive information like taking photographs of their wounds.

Summary of the significant findings

From the study, nurses found that there were no significant differences in the healing periods of the three groups. Moreover, they found no significant differences between health-caused bacterial weight and value of life. This study leaves the researchers wondering if debridement helps to treat leg ulcers. In spite of nurses considering debridement as a crucial component in preparation of the lesion bed, there is limited data that associates debridement with healing. Hence, the nurses need to carryout a research about the correlation between debridement and microbiology to know the significance of debridement in treating leg ulcers.

Conclusion

This paper has decisively evaluated the study about the efficacy of larval therapy in curing venous ulcers. The paper has analysed the research systematically with respect to design, sampling technique, and method of data collection, study tools, biases, ethics, and significant findings. Through the analysis, the paper has demonstrated that study design helps the researchers to analyse varied variables without challenges.

On the other hand, the paper has shown that data collection and sampling techniques contribute to the validity and reliability of the research findings. This paper acts as an eye opener for individuals who have never conducted a research. It educates them on how to prepare for a research. From here, nurses ought to use the findings of this paper to prepare for a comprehensive research that will help to determine the relationship between debridement, microbiology and healing. This will go a long way towards treating patients suffering from venous ulcers.

Reference List

Beauchamp, T & Childress, J 2001, Principles of Biomedical Ethics (5th ed.), Oxford University Press, Oxford.

Burns, N & Grove, S 1997, The Practice of Nursing Research: Conduct, Critique and Utilization (3rd ed.), WB Saunders Company, Philadelphia.

Hootman, J 2002, ‘The importance of research to school nurses and school nursing practice’, The Journal of School Nursing, vol. 18 no. 1, pp. 18-24.

Lindsay, B 2007, Understanding Research and Evidence Based Practice, Reflect Press, Exeter.

Parahoo, K 2006, Nursing Research: Principles, Process and Issues (2nd ed.), Palgrave Macmillan, Houndmills Basingstoke.

Polit, D & Beck, C 2006, Essentials of Nursing Care: Methods, Appraisal and Utilization, Lippincott Williams and Wilkins, Philadelphia.

Russell, C 2005, ‘Evaluating quantitative research reports’, Nephrology Nursing Journal, vol. 32 no. 2, pp. 61-64.

Tanner, J 2003, ‘Reading and critiquing research’, British Journal of Perioperative Nursing, vol. 13 no. 4, pp. 162-164.

Valente, S 2003, ‘Research dissemination and utilization: improving care at the bedside’, Journal of Nursing Care Quality, vol. 18 no. 2, pp. 114-121.

Wood, M, Ross-Kerr, J & Brink, P 2006, Basic Steps in Planning Nursing Research: From Question to Proposal (6th ed.), Jones and Bartlett, Sudbury.