Introduction
This essay is a critique of a quantitative nursing research study. It examines the effectiveness or otherwise of research conducted by Josephine M. Mancuso to study the impacts of health literacy and patient trust on glycemic control in a semi-urban American population. The researcher wanted to identify variables that play central roles in improving the health of patients suffering from diabetes. In addition, the researcher wanted to examine the influences of health literacy, patient trust, knowledge of diabetes, the performance of health care activities, and depression on glycemic control in uninsured individuals. The results of this research explained the existence of relationships between these variables and glycemic control. Mancuso was interested in examining the influences of social status and health on the variables mentioned above and how this affects the processes of managing diabetes. The researcher is a credible and reliable professor at the College of Nursing, Marquette University, Wisconsin, America. She obtained approval from the institutional review board of the University and permission letters from the directors of the two primary care clinics that provided patients for the study.
Variables
The researcher examined a set of two variables that formed the basis of this research. Health literacy and patient trust were the primary independent variables that were considered in the study. The researcher used various approaches to examine how these variables affected glycemic control. Health literacy was defined as the level of an individual’s awareness of diabetes, how it is controlled ,and measures that may be taken to achieve positive results. She observed that this variant played significant role in determining the success of other initiatives of glycemic control. The researcher made sure that all participants were able to read and write to ensure they understand the research questions contained in the questionnaire. Secondly, patient’s trust was another independent variable that was noted to affect glycemic control. The researcher used this variable to examine the level of patients’ cooperation with nurses and other stakeholders involved in providing care for them. These two variables were the major ones that proved to play significant roles in determining the success or failure of glycemic control. Depression became a variable in occasions where nurses reported reduced glycemic management in patients that had mental and emotional instability. This factor influenced patients’ communication and cooperation with caregivers and family members (Centers for Disease Control and Prevention and Prevention, 2011). The research revealed that patients who experienced frequent depressions did not manage diabetes effectively. Diabetes knowledge and performance of self-care activities were related and played similar roles in influencing the success of other initiatives to control glycemic. The research achieved a highly credible conclusion that revealed how these independent variables affected the outcome of the efforts to control diabetes.
Design
The researcher used a comparative approach to conducting the survey and established the relationship between independent (health literacy, patient trust, knowledge of diabetes, the performance of self-care activities ,and depression) and a dependent variable. Most of the independent variables had relationships that affected the performance of each other while the dependent variable was HbA1c. This design helped the researcher to identify the relationships between variables and how they influence each other in improving or worsening the conditions of a diabetic patient. There was a high level of acceptable reliability because the researcher used a pilot study to determine the appropriate way of calculating the size of the sample population. In addition, the plot established a feasible design and analysis criterion and ensured the procedures were well structured.
Strengths
Credibility. The results of this study were credible because the researcher used various approaches to enhance the accuracy of the data collected. First, the participants were not forced to participate in the survey. They were supposed to volunteer and understand their roles in the research. Credibility in research is enhanced by the willingness of participants to take part in a study. Secondly, there is a close relationship between the data sets collected from the field. The tables showing the results and feedback from participants show similarities in their responses. This means that the data was credible because it was derived from participants who knew and accepted to play the assigned roles. Credibility is a critical research quality because it attracts the attention of relevant stakeholders who may provide assistance and fund further research. In addition, the research findings may be used by government and private agencies to improve the lives of the targeted population.
Accurate Sample Population. The strengths of a gd research are determined by how the sample size represents the targeted population (Mancuso, 2010). The researcher used participants from two health care facilities of a homogeneous nature. She ensured that these participants were of age and understood what they were doing. The criterion used to select the sample size ensured the entire population was represented adequately. In addition, all the participants had a similar record of having suffered diabetes for more than two years and were checked by physicians at least twice within the last year. An accurate sample population is a major strength in a survey because it ensures the researcher gets information as it appears on the ground. Therefore, the research provides accurate and reliable information.
Timelessness. The researcher conducted an extensive literature review and examined various aspects discussed by other scholars. She examined the methods used to manage diabetes in the past and how far they have gone in improving the livelihoods of patients. In addition, the research has covered key issues related to government policy and diabetes and how different populations are affected by this epidemic. Lastly, the research objectives give a glimpse into the future of diabetic patients and the entire population if effective measures are not taken to alleviate this problem.
Weaknesses
Biased Sample. The research focused on participants that reside in a particular area. It is correct to argue that she wanted to examine the impacts of health literacy and patient trust in the measures of alleviating the challenges posed by diabetes. However, the American population consists of people from diverse backgrounds. There are wealthy non-Native Americans who live in urban areas and can afford to pay health insurance covers. The researcher assumed that the participants represented the entire population of African/Americans, Hispanic and Caucasians living in the United States. Therefore, the study was unbiased, and that is why its findings may not be the actual representation of the entire population. This weakness may lead to the establishment of biased policies of alleviating the problems of diabetes in the United States. In addition, the researcher excluded children, even though, recent studies show that they are increasingly becoming the easiest victims of diabetes due to a sedentary lifestyle.
Research Design. The cross-sectional study design used by the researcher was very complicated, and this means that it was not easy to focus on the objectives of this study. A lot of independent variables were used to study the dependent variable, and this led to a multifaceted response from participants. The primary independent variables were health literacy and patient trust. However, these variables were not independent because they were controlled by other independent variables like depression, race, and education (Hajjar & Kotchen, 2013). The researcher had a hard time focusing on the main areas of study because of the complexities associated with this study design. In addition, it is not easy to draw conclusions that narrow the scope of the study if there are other external factors that influence the roles of independent variables. This weakness affects the quality of research findings and may misdirect the researcher.
Poor Response. The researcher realized that it would be difficult to persuade the participants to respond to the questionnaires if they were not given handouts. The $50 given to all participants might have contributed to a high number of them willing to take part in the research. Most people living in the targeted regions are poor, and they would do anything to get money. Some of them may not know that the research findings would be used for other important purposes apart from understanding the situation on the ground. There is a likelihood that some illiterate participants filled the questionnaires without knowing what they were doing. In addition, most of them were influenced to participate in the study by the expected economic gains. Lastly, most people do not like exposing their health conditions to the public. The researcher used a coding system to conceal the identity of the participants. However, this was not a guarantee that some of them did not provide accurate information for fear of being exposed to the public.
Application of Evidence-Based Practice
Nursing Research. The research findings are an important aspect that contributes to the rich volume of information regarding diabetes management. Mancuso focused on the most vulnerable populations (poor, uninsured non-native Americans) who live in the suburban areas (Diabetes Prevention Program Research Group, 2012). The information obtained from the study is helpful in forming the basis for further research and also contributing to academic materials for nurse trainees. Appropriate sample population and credibility of the findings of this research are the major strengths that contribute to making this article an important educational reference material.
Nursing Practice. The data presented in this research article reflects the actual events =on the ground. The accuracy and credibility of these results make this article very relevant in helping nurses to improve service delivery. They can use the information presented to help patients understand their self-care responsibilities.
Conclusion
Josephine M. Mancuso’s article on the impacts of health literacy and patient trust in glycemic control in an urban American population is a piece of immense value to nurses, patients and governments across the globe. She used two sets of variables (independent and dependent) to examine how the success of glycemic control is influenced by various factors. In addition, she used a cross-sectional design to identify and use these variables to conduct the research. This design enabled her to know the specific roles of each variable. The main strengths of this research include credibility and sample and time appropriateness that allows the research to be appropriate for America. However, the use of a complicated design, biased sample and money to pay participants are serious weaknesses that may affect the accuracy and credulity of the research. Finally, the research has abundant information that is appropriate in the application of evidence-based practices in nursing. It is a suitable piece that will add knowledge in nursing institutions and enable nurses to use practical approaches that are applicable in their settings.
References
Centers for Disease Control and Prevention (CDC), & Centers for Disease Control and Prevention (CDC). (2011). National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, 201.
Diabetes Prevention Program Research Group. (2012). Reduction in the incidence of Type 2 diabetes with lifestyle intervention or metformin. The New England journal of medicine, 346(6), 393.
Hajjar, I., & Kotchen, T. A. (2013). Trends in prevalence, awareness, treatment, and control of hypertension in the United States, 1988-2000. Jama, 290(2), 199-206.
Mancuso, J. M. (2010). Impact of Health Literacy and Patient Trust on Glycemic Control in An Urban USA Population. New Jersey: Blackwell Publishing.