Research Topics: Critical Analysis Paper Sample

Critical Analysis of Research: Journals on Tonsillectomy

Critical Analysis of Research: Journals on Tonsillectomy   Abstract             The three articles all discussed and provided relevant explanations on the different strategies on how to alleviate pain related to tonsillectomy. One of the articles tested two different techniques on how tonsillectomy should be done to patients, by lessening the sound of their snoring. The two techniques include the coblation-assisted uvulopalatoplasty with tonsillectomy or CP and the standard palatoplasty technique, the KTP LAUP. Results indicate that the use of CP enables participants to experience more painful post-operative recovery but more controlled snoring.             Similarly, the post-operative pain management in participants was also the second article through provision of analgesia. Post-operative pain management in this article involves seeking to decrease nausea, pain, and vomiting, with which have been achieved through provision and administration of dexamethasone. In addition to the effective action of the analgesia to the post-operative pain management of participants, using dexamethasone was also said to be economic, and produced no known adverse side effects to the participants.             The third and final article used in this paper also aimed to help participants to manage pain associated with tonsillectomy through regional nerve blocks. In order to see the effect of nerve blocks to pain, three groups were studied, namely, the group administered with bupivicaine, saline, and the group with no injection.      Content   Abstract                                                                                                                      1 Contents                                                                                                                    2 Introduction                                                                                                               3 Justification of Selection of the Articles for Primary Research                                   4 Analysis of Evidence                                                                                              5             1. Randomized-controlled study comparing post-operative pain         5 between coblation palatoplasty and laser palatoplasty by Belloso et al (2006)               2. Use of intravenous steroids at induction of anesthesia                     7 for adult tonsillectomy to reduce post-operative nausea and vomiting and pain: a double-blind randomized controlled trial by McKean et al (2005)               3. A randomized controlled trial of the effect of regional nerve             9 blocks on immediate post-tonsillectomy pain in adult patients by El-Hakim et al (2000)   Factors influencing implementation of findings                                                            11 Conclusion                                                                                                               13 References                                                                                                               15      Introduction             It has been reported that tonsillectomy is the most common ENT ward operation that has traditionally required overnight stay among patients (Dennis et al 2000). It has now prevalent in many individuals due to different medical reasons, such as snoring, bacterial tonsillar infections, chronic tonsillitis that is not responding to medical management and antibiotics, the presence of obstructive sleep apnea syndrome or OSAS, difficulty swallowing because of the enlarged tonsils, or the suspicion of tonsillar malignancy (Loury and Schaffer 2006). Because anybody can experience such causes or symptoms, anybody is susceptible to undergoing tonsillectomy. Thus, the main reason for choosing the topic is to gather relevant knowledge on how to help patients manage post-operative pain due to tonsillectomy.             Tonsillectomy is done through surgery under general anesthesia, such as through dissection, coblation, and bipolar diathermy (Yung 2000). This also involves the use of laser, which hastens recovery and healing. Because the process of tonsillectomy involves a painful procedure, nursing practitioners play an important role in post-operative pain management. This is because nurses, given the knowledge and skills to care for their patients effectively and appropriately, would be able to provide adequate and effective care and attention to their patients, particularly, with regards to their condition.      Justification of Selection of the Articles for Primary Research             It has been reported that primary research or field research involves gathering data that have not been existing in the previous body of knowledge. In order to gather the needed data, different methods can be used, including direct observation, experimentation, surveys (‘Primary Research’ 2008), and interviews. In this regard, it can be understood that primary research is being done by actually making a new research or study that no one has ever done before and gathering data from participants or respondents directly. Based on the three articles being referred to, it can be perceived that the authors have been successful in making its primary research regarding post-operative pain management in relation to tonsillectomy. The studies used large numbers of participants in order to support their pilot study. This is because by using large numbers of participants, results and findings of the studies will be appropriately justified.             Moreover, all the studies discussed different strategies that can be used for post-operative pain management in relation to tonsillectomy. Because it featured varied techniques in post-operative pain management, it discussed and provided varied results and opinions regarding managing tonsillectomy. The articles did not mention that their study has been based from other studies, thus, making their studies legitimately primary. In relation to this, the studies provided useful and relevant results and findings that can be based upon and used by other studies or researches in the same field. It also offered suggestions or recommendations on how the studies can be improved, in order to effectively and appropriate assess post-operative pain management, which can be used for future practical applications. In this regard, it can be understood that all the three articles have been successful in communicating their ideas and opinions to the readers, through their experiments, direct observation, and interviews.   Analysis of Evidence 1. Randomized-controlled study comparing post-operative pain between coblation palatoplasty and laser palatoplasty by Belloso et al (2006)   Method. This study used a single blind randomized trial, which means that the researcher knows the details of the treatment but the patients or respondents do not, thus, in this sense, the researcher can treat the patient differently, influencing the outcome of the study (‘Randomized Control Trial’ 2008). It has been indicated in the study that the study population consisted of patients undergoing uvulopalatoplasty, and no further contact between the patients and the researchers was allowed. The randomization was predetermined by computer random-generated number (Belloso et al 2006). Sample. In order obtain the sample population, inclusion criteria were given emphasis, namely, simple snoring, participants with age of over 18 years, having the ability to understand the study, along with obtaining consent, having no cardio-vascular or chronic respiratory disease, diabetes, hematological and neurological disorders, no regular use of analgesia, and no concomitant surgery. The study population consisted of 17 patients in the CP group, with 13 males and 4 females, and the LAUP group consisted of 13 patients, with 9 males and 4 females (Belloso et al 2006). Data Collection. The needed data was collected by setting up two different groups, namely, the CP group and the LAUP group. In the CP group or the coblation-assisted uvulopalatoplasty with tonsillectomy group, the surgical procedure was performed under microscopic vision using an ArthroCare Evac. A routine coblation tonsillectomy was done using settings 6 and trimmings of the soft palate/uvula and triangular submucosal resection of the soft palate using settings 7-8. On the other hand, in the LAUP group or the standard palatoplasty technique, the surgical procedure was limited to an excision of the soft palate/uvula and triangular submucosal resection of the soft palate, without tonsillectomy. A KTP/532 Laser was used, with a delivered energy of 12W in a continuous exposure mode (Belloso et al 2006). Data Analysis. It has been indicated in the study that in the CP group, tonsillectomy in the surgical resection was included, which was not present in the LAUP group. It has been stated that the addition of tonsillectomy to palatoplasty produced a better reduction of snoring and OSAS. Although the process is more painful and takes a long time for recovery, better long-term snoring control was achieved. On the other hand, more severe muscular and mucosal damage have been observed in the LAUP group due to thermal tissue injury caused by laser. This caused delay in the healing process of the participants in the LAUP group and caused them discomfort (Belloso et al 2006). Findings. Findings of the study stated that both surgical techniques proved to be adequate options in the treatment of snoring, which is one of the causes for tonsillectomy, as both produced similar early post-operative reduction of snoring. However, the LAUP group had better long-term results compared to the more mutilating surgery involved in the CP group, although the CP group were expected to produce greater decrease in snoring loudness. This was due to the fact that the LAUP group had thermal injury inflicted by the laser, which increased scaring and tightening of the soft palate, thus, causing decrease of palate mobility and reduction of snoring level (Belloso et al 2006).   2. Use of intravenous steroids at induction of anesthesia for adult tonsillectomy to reduce post-operative nausea and vomiting and pain: a double-blind randomized controlled trial by McKean et al (2005)               Method. This study was a double-blind, randomized, prospective trial, which means that not all researchers know the series of numbers involved in the treatments of the participants, thus, not making the treatment known to the patients. A more realistic distribution of the sexes and ages of the patients can be achieved, thus, giving more accurate results (‘Randomized Control Trial’ 2008). In order to observe ethics, approval was obtained from the Local Research Ethics Committee to make sure that probable risks and problems are considered against expected advantage for the individual trial subject and for the entire society (McKean et al 2005).             Sample. Seventy-two consecutive patients were considered for the study, which have met the inclusion criteria, and were enrolled in a 10-month period. However, only 24 participants returned considerable results. Inclusion criteria included age 16-70 years, ASA score 1 and weight 50-100kgs. Exclusion criteria of the participants include presence of suspected diagnosis of malignancy, both of which for unilateral tonsillectomy and contraindications to the use of non-steroidal and anti-inflammatory drugs (McKean et al 2005).             Data Collection. The 24 participants were divided into two groups, namely, the control and the trial group. The control group, which consisted of 22 participants received 2mL of normal saline intravenously at induction of anesthesia, while the trial group, which consisted of 24 participants received 10mg or 2mL of dexamethasone intravenously at induction of anesthesia. The trials include analyzing three areas, including pain, PONV, and time taken to ingestion of food and diet (McKean et al 2005).             Data Analysis. Results of the study suggest that there was no significant difference in terms of PONV and first ingestion of food and drink in both groups. However, the difference in the two groups lies on their pain scores. It has been stated that the pain scores of the trial group were lower than the pain scores of the control group. In addition, this was further supported by the fact that the pain scores were significantly lower for the day of operation, and the other days consecutively. It was reported that oftentimes, the most pain is felt after tonsillectomy, during the second and third days after the operation. In the trial group, where dexamethasone was administered, inflammation of the operative site was reduced, thus, reducing the release of inflammatory mediators into the circulation, and in turn, lead to lesser stimulation of the vomiting center (McKean et al 2005).             Findings. Findings of this study suggest that a single dose of 10mg of dexamethasone, given intravenously at induction of anesthesia to the participants in the trial group, due to adult tonsillectomy decreased the pain scores to the day of operation. In addition, in the trial group, post-operative nausea and vomiting was also reduced significantly for the day of operation. Moreover, the mean pain scores for the participants in the trial group were significantly lower compared to the mean pain scores of the control group. There was also no significant difference between the time to first ingestion of food and drink and PONV. More importantly, economic benefits have been said to be achieved with reduced need for analgesia and anti-emetics, and no adverse side effects were observed among participants (McKean et al 2005).   3. A randomized controlled trial of the effect of regional nerve blocks on immediate post-tonsillectomy pain in adult patients by El-Hakim et al (2000)               Method. A stratified block randomization method was used to ensure equal and balanced allocation of patients according to sex to the groups at all times, and men and women were randomized independently in blocks of three. This process was organized in each two centers separately using computer generated random number tables. The clinical trials were run in the otolaryngology departments of two teaching hospitals, namely Aberdeen Royal Infirmary and Ninewells Hospital and Medical School. Similar to the other two studies, ethical committee approval was also sought in both centers (El-Hakim et al 2000).             Sample. Adults patients over the age of 16 years suffering from chronic or recurrent acute tonsillitis and listed for tonsillectomy were recruited. Participants were excluded if they had a history of chronic pain, alcohol abuse, hepatic disease, cardiac disease, seizures, or allergy to amide anesthetics. In addition, patients who used analgesia within 48 hours or those who used systemic antibiotics within 7 days prior to tonsillectomy were also excluded. The study also excluded patients with a history of a peritonsillar abscess or a recent attack of acute pharyngitis (El-Hakim et al 2000).             Data Collection. It has been stated that two surgeons performed the procedures using a bipolar diathermy tonsillectomy technique, and a standard anesthetic technique. Ninety-two participants were considered for the study and were divided into three separate groups. The bupivicaine group, which comprised of 29 patients, received 5mL of 0.5% bupivicaine. The second group, the placebo group, which is comprised of 30 patients, received a ‘placebo’ injection 0.9% saline employing the same volumes and injection technique. Lastly, the third group is the no injection group, which is comprised of 33 patients, received no injection. In addition, in order to administer the nerve blocks, an angled tip needle, 1cm long, is introduced at the midpoint of and 0.5cm behind the posterior tonsillar pillar. It was directed laterally and lie between the superior and middle constrictors of the lateral pharyngeal wall, which is adjacent to the nerve. Moreover, the lesser palatine nerve block was performed by introducing a needle, which is placed lateral to the base of the uvula in order to raise on infiltration a mucosal fold in the supratonsillar fossa (El-Hakim et al 2000).             Data Analysis. Analysis of the obtained data suggests that the sex, weight, and age distribution of the patients in all three groups did not create significant differences. No significant difference was also observed in terms of the post-operative pain scores of all participants in three groups. In addition, the consumption of analgesics of patients in three groups was the same, along with their blood pressure values. However, some of the patients in all three groups developed a secondary post-tonsillectomy bleed. No other side effects or complications were indicated (El-Hakim et al 2000).             Findings. Findings of the study indicate that patients in the bupivicaine group experienced more severe pain in the morning after surgery compared to the patients belonging to the two other groups. This means that adults who undergone tonsillectomy do not derive benefits from the use of bupivicaine in their aim to block the glossopharyngeal and lesser palatine nerves (El-Hakim et al 2000).   Factors influencing implementation of findings             Based on the findings of the three articles, it can be perceived that such findings can help the advancement of the field of tonsillectomy, particularly the individuals that undergo the process. However, different factors influence how they can be implemented. One of such factors includes the practices, behaviors, skills, and knowledge of the nurses or health practitioners. Because they are the ones responsible for the treatment of the patients, they must have adequate knowledge and skills regarding the process. However, such relevant and useful findings cannot be implemented if the knowledge and skills of the health care practitioners would not be able to support the techniques they would use. This is then related to their faulty administration of the technique, thus, resulting to disastrous consequences. Another factor to consider is the lack of effective communication between experts, which does not help clarify the right process of the use of the technique. The third factor is the wrong misconceptions and practices of the patients, which either worsens their condition or put them at risk of undergoing tonsillectomy. The lack of communication with healthcare practitioners leads them to observe practices that affect them significantly. The fourth and final factor to consider is the lack of funds or support from the government or from the individuals that must be concerned in helping to find the evidences for the techniques. The lack of funds and support hinders such relevant findings to be implemented because the number of participants, time to accomplish the study, and the techniques to be used will all be limited, based on the available funds.             In this sense, the primary recommendation is to seek for funds or support from the government so that adequate funds for the accomplishment of the study can be achieved. Through adequate support and funding, the materials, methods, participants, and time involved in the study would be sufficient in order to produce accurate, relevant and useful findings. In line with this is the second recommendation, which is to suggest that more researches must be done in order to gather evidences and data to support the existing body of knowledge. This would also help add to the existing knowledge regarding tonsillectomy and correct the wrong findings or misconceptions about it. Through more researches, updating the existing findings of the researches would be done, in line with the advancement, improvement, and development of today’s technology, communication, and science. In this sense, it would be easier for healthcare practitioners to assess the right technique or strategy for a more effective tonsillectomy process. This would also be helpful for patients in post-operative pain management. The third recommendation is providing improved education and training to all healthcare practitioners, in order to assist the nurses to implement effective healthcare to patients. Through effective education, communication among the healthcare practitioners and communication with their patients would also be achieved, thus, enabling more effective treatment and healthcare.   Conclusion             From the discussion, it can be deduced that the process of undergoing surgical tonsillectomy is a tedious and painful process that would require the cooperation, support, and concern of the patients and the healthcare practitioners as well. Three journal articles were given emphasis, which all aimed at helping patients manage post-operative pain in relation to tonsillectomy. Similarly, all these three articles came up with different strategies or techniques that aimed at post-operative pain management of patients that had undergone tonsillectomy. The three articles came up with separate findings that can be practically used in actual cases and can be used as bases for other researches.             However, although the findings of the articles were equally relevant and useful, a number of factors possibly impede the use or implementation of such findings in actual situations. Among the factors that limit the implementation of the findings include the lack of government funding and support, the lack of communication, knowledge, and skills of healthcare practitioners and patients, and the lack of more researches and evidences to support the effectiveness of the findings. As such, recommendations include provision for funds and support from the government, improvement and development of education and training of healthcare practitioners, education and communication with patients, and coming up with more researches on the field.   References Belloso, A, Morar, P, Tahery, J, Saravanan, K, Nigam, A and Timms, MS 2006, ‘Randomized-controlled study comparing post-operative pain between coblation palatoplasty and laser palatoplasty’, Clin. Otolaryngol, vol. 31, pp. 138-143. Dennis, S, Georgallou, M, Elcock, L and Brockbank, M 2000, ‘Day Case Tonsillectomy – The Salisbury Experience’, The Journal of One-Day Surgery, vol. 14, no. 2, pp. 17-22. El-Hakim, H, Nunez, DA, Saleh, HA, Macleod, DM and Gardiner, Q 2000, ‘A randomized controlled trial of the effect of regional nerve blocks on immediate post-tonsillectomy pain in adult patients’, Clin. Otolaryngol, vol. 25, pp. 413-417. Loury, MC and Schaffer, SB 2006, Advanced Otolaryngology, viewed 25 March 2008, <http://www.drlouryent.com/Pages/PatientServices/1066.html>. McKean, S, Kochilas, X, Kelleher, R and Dockery, M 2006, ‘Use of intravenous steroids at induction of anaesthesia for adult tonsillectomy to reduce post-operative nausea and vomiting and pain: a double-blind randomized controlled trial’, Clin. Otolaryngol, vol. 31, pp. 36-40. O’Deane, KH 2006, Randomized Controlled Trial Design, British Journal of Occupational Therapy, vol. 69, no. 5 O’Deane, KH 2006, Randomized Controlled Trial Reporting, British Journal of Occupational Therapy, vol. 69, no. 6. Polit, DF and Beck, CT 2006, Essentials of Nursing Research: Methods, Appraisal, and Utilization, 6th ed., Lippincott Williams & Wilkins, Philadelphia. ‘Primary Research’ 2008, Wikipedia, the Free Encyclopedia, viewed 25 March 2008, <http://en.wikipedia.org/wiki/Primary_research>. ‘Randomized Controlled Trial’ 2008, Wikipedia, the Free Encyclopedia, viewed 25 March 2008, <http://en.wikipedia.org/wiki/Randomized_controlled_trial>. Yung, M 2000, ‘Report of a National Survey of Tonsillectomy’, pp. 1-11.                                                    Credit:ivythesis.typepad.com

Critical Analysis of Research: Journals on Tonsillectomy

Critical Analysis of Research: Journals on Tonsillectomy Abstract The three articles all discussed and provided relevant...

Critical Analysis of Published Literature

Critical Analysis of Published Literature   Introduction             Today, research in health sciences is important most especially that different diseases have already been discovered and occurring in the general population. In this regard, research in health sciences provides additional knowledge to the existing body of knowledge regarding health sciences. In addition, research in health sciences helps individuals concerned to prepare and respond to different health risks due to diseases, environmental hazards, and other threats, along with the improvement and development of new safe and effective drugs. Moreover, such researches will help guide and develop policy guidelines for the development of the field.             In relation to doing research in the health science field, critical analysis and thinking skills must be needed. Critical analysis skills involve effectively sorting out ideas, concepts, facts, and opinions gathered from other sources. This is needed in order to either agree with or negate the existing bodies of knowledge, in order to enhance the field. In addition, having critical analysis skills involve gathering additional knowledge and information to support new evidences found.             Research in health sciences can be further improved through critical analysis skills, and may also be used in evidence based practice. This approach enables healthcare practitioners to provide the highest quality of care in meeting the different needs of their clients and families. Thus, in this sense, when healthcare practitioners, particularly nurses know how to find, critically evaluate, and use the best evidence, and when clients are confident that their healthcare providers are using evidence-based care, optimal outcomes can be achieved for all (Melnyk and Fineout-Overholt, 2005).   Health related research and reviewing the literature             The field of advanced nursing practice is essential in healthcare, as it helps provide care, protection, and attention to individuals, particularly to patients. It includes the functions and duties carried out by persons who have had formal education and training in the art and science of the nursing field (Gubrium and de Gruyter, 1993). Being essential in the healthcare field, certain functions and practices are being observed by advanced practical nurses in order to provide effective and efficient services to those who need them.             Advanced nursing practitioners have a number of roles to assert in their profession, namely, as clinicians who help diagnose, treat diseases, prescribe medications, and develop treatment plans; as educators; as policy makers who come up with policy guidelines in order to provide order in the healthcare field; as consultants, and as researchers. In line with such roles, the importance of researches in the health sciences can be recognized. One of such importance is for preparing and responding to different health risks associated with threats from the environment, which can pose danger to the health of people. Another importance of research in the health sciences is having the knowledge and updated information on the latest trends and discoveries in relation to treatment, which serves as a primary concern of advanced nursing practitioners. Third importance is the improvement and development of policies in relation to the use, manufacture, and administration of food, drugs, and other consumer products. The last importance of research in the health sciences is the promotion and protection of health of people (“Importance of Science and Research”, 2007).             In relation to the importance of research to health sciences is the article done by Cheevakasemsook et al (2006), which discusses the complexities in nursing documentation. According to the study, complexities in documentation include three factors, namely, disruption, incompleteness, and inappropriate charting, with additional factors, such as limited competence of the nurses, motivation and confidence, ineffective nursing procedures, and inadequate audit, supervision, and staff development (Cheevakasemsook et al., 2006). This was further supported, as different activities that serve as barriers to such activities have been cited, namely, the shortage of nursing staffs, greater emphasis on other activities, such as drug therapeutic treatment and research, and education, and few individuals or staffs (Smesny, 2007). In this case, the findings of Smesny (2007) is consistent with the findings of Cheevakasemsook et al (2006), as the shortage of staffs and emphasis on other activities serve as barriers to nursing documentation. As one of the solutions, von Krogh and Naden (2008) came up with the Norweigan documentation KPO model (quality assurance, problem solving, and caring) as a tool for nursing documentation and meeting statutory, organizational, and professional requirements. In this regard, it can be perceived that nursing documentation is an important aspect of research in health sciences because it can provide additional knowledge and information that would benefit the advancement of the nursing field. As such, the different barriers and complexities of nursing documentation must be overcome through relevant policies, models, and strategies.   Ethical concepts in health related research             The field of health care research in relation to the nursing practice involves ethical criteria. This is because the safety, protection, and the assurance of obtaining useful and relevant findings or results of the research must be ensured. One of the main ethical considerations identified is the exposure of the subjects of the health related research to environmental hazards by economic or political oppression (Lavery et al., 2003). This may be attributed to the fact that most of the subjects asked to participate in such researches suffer from incurable diseases, thus, having the belief that participation in such researches may provide them the cure they need. However, this increases their risk to become exposed to deleterious substances without clear biological responses and without clear measurement and characterization of its harmful effects (Lavery et al., 2003). Another ethical criterion for health related research includes the emotional factors, nested and mediated in the organic hierarchy of the ecologically-defined community, comprising psychological, social, cultural, and political elements (Samuels, 1997). This is because only a few people would be willing to risk their lives to become “guinea pigs” or “lab rats” for research. In this sense, moral, religious, and social matters must still be discussed. Third ethical consideration is the provision of laws, policies and practices, including required requests (Childress, 1989) in relation to research, such as the use of animal or human subjects. This also involves the rights to patenting in the event that the research has been successful and the sales or marketing of the developed cure. As such, such ethical criteria may be deemed important for the provision of medication, treatment, and drug administration of healthcare practitioners. However, extensive research must be done to come up with the right dosage and amount of medicine or drug to prescribe patients.             In relation to this is the article done by Schelbred and Nord (2007), which discusses the serious medication errors committed by nursing practitioners. Schneider et al. (2006) reported that the rapid proliferation of new drug devices and products, increasing both the complexity in medication regimens, and nursing workload contribute to committing serious medication errors, and are thus, being blamed for 38% of all adverse drug events. This is being supported by the fact that administration errors involving continuous IV or intravenous infusions occur frequently (Han et al., 2005). Because of this, it has been found out that serious medication errors have a great impact on the nursing practitioners, both personally and professionally (Schelbred and Nord, 2007). As such, different interventions have been identified as means of providing solutions for committing serious medication errors. Interventions include educational interventions, such as the use of an interactive CD-ROM (Schneider et al., 2006), constant and relevant communication, and the use of new technology directed at reducing medication administration errors (Schneider et al., 2006). Because serious medication administration errors pose disastrous consequences for patients and for healthcare practitioners as well, it can be suggested that it would be necessary to allow and support researches in health sciences.   Qualitative research design and method             It has been reported that qualitative research is more subjective in nature compared to quantitative research. It involves examining and reflecting on the less tangible aspects of a research subject, such as values, attitudes, and perceptions (Neville, 2005). In addition, in using a qualitative research method, it intends to find and build theories that would explain the relationship of one variable with another variable through qualitative elements. These qualitative elements do not have standard measures; rather they are behavior, attitudes, opinions, and beliefs. Moreover, as we define the qualitative research, it is a multi-method in focus, involving an interpretative, naturalistic approach to its subject matter. This means that qualitative researchers study things in their natural settings, attempting to make sense of, or interpret phenomena in terms of the meanings people bring to them. Accordingly, qualitative researchers deploy a wide range of interconnected methods, hoping always to get a better fix on the subject matter at hand. Through qualitative research methods, verbal data that is obtained through observations, surveys, interviews, and questionnaires are being obtained, rather than scaled, calibrated measurements (Thomson, 2007). From such information, it can be understood that the values, opinions or perceptions, attitudes, behaviors, theories, and verbal data, such as direct observations, interviews, surveys, and actual questionnaires are the key elements of the qualitative research method and design.             The study done by Holmes et al (2005) discusses the injection-related practices in two rural north Indian health settings, which contribute to the increase of risk of acquiring blood-borne viral diseases (BBV). The study indicated that it used qualitative data collection methods, including participant observation and in-depth interviews. Such method led the authors to conclude that strategies for promoting injection safety are needed in order to lessen the risk of acquiring BBV diseases (Holmes et al., 2005). From this, it can be perceived that the key elements were essential for arriving at such results and conclusions. Through direct observations and interviews, the authors have come up with sound conclusions regarding what to do in order to provide solutions to the problem presented.             In addition, through the qualitative research method that used direct observations and interviews, it can be stated that the authors engaged in an action research, which is a style of research that is particularly suited to identify problems in clinical practice and help develop potential solutions in order to improve practice (Meyer, 2000). Through this type of research method, the understanding of the study’s objectives (Poggenpoel and Myburgh, 2005) has been achieved. Although other forms of strategies have been devised in line with using a qualitative research method, such as intuiting, bracketing, and inferencing (Poggenpoel and Myburgh, 2005), the used methods in this particular study have been satisfactory and sufficient to produce relevant and useful strategies, opinions, and conclusions in relation to the problem specified. In addition, the opinions, attitudes, behaviors, and perceptions of the participants mattered in the study, as their perceptions regarding the issue and the study have made it more useful in relation to the health science research.      Conclusion             A number of importances of research in the field of health sciences include preparing for known risks and dangers to the health of many individuals, adding up or correcting the existing body of knowledge regarding the field, improving the manufacture and administration of food, drugs, and substances in the market, and overall promotion and protection of health of people. These different aspects augment the roles of nursing and other healthcare practitioners in relation to healthcare provision. In addition, a number of barriers or complexities to proper nursing documentation have been identified, which somehow affect the type of information being indicated in health sciences researches. As such, barriers must be overcome in order to provide more effective and efficient healthcare to patients or clients.             Moreover, in order to make a good health science research, ethical considerations must be emphasized. In order to make a relevant, useful, and substantial health science research, ethical criteria must be given consideration so that the study would be supported, financed, and given attention by all the individuals, particularly of the participants involved. As such, the ethical criteria to be considered must serve as guide for the individuals undergoing the research, as much as they would be placing high regard for policies and guidelines involved in research. They must make sure that their research will not be pressing harm on the individuals involved, particularly to them and to the chosen participants or subjects.             Furthermore, the qualitative research method is one method that would effectively help express the relevant opinions, ideas, and perceptions of the individuals involved in a health science research. Through the qualitative research method, the solutions for different problems can be easily communicated.   References Cheevakasemsook, A., Chapman, Y., Francis, K., and Davies, C. (2006). The Study of Nursing Documentation Complexities. International Journal of Nursing Practice, 12(6): 366-374. Childress, J.F. (1989). Ethical Criteria for Procuring and Distributing Organs for Transplantation. Journal of Health Politics, Policy and Law, 14(1): 87-113. Gubrium, J. and de Gruyter, A. (1993). Speaking of Life: Horizons and Meaning for Nursing Home Residents. Hawthorne, NY: Aldine de Gruyter. Han, P.Y., Coombes, I.D., and Green, B. (2005). Factors Predictive of Intravenous Fluid Administration Errors in Australian Surgical Care Wards. Qual Saf Health Care, 14: 179-184. Holmes, K.M., Thomas, L.B., and Gifford, S. (2005). Safe Injections, Fewer Infections: Injection Safety in Rural North India. Tropical Medicine and International Health, 10(5): 423-432. “Importance of Science and Research”. (2007). Science & Research. Retrieved March 27, 2008, from http://www.hc-sc.gc.ca/sr-sr/about-apropos/importance/index_e.html. Lavery, J.V., Upshur, R.E.G., Sharp, R.R. and Hofman, K.J. (2003). Ethical Issues in International Environmental Health Research. Division of Advanced Studies and Policy Analysis. Melnyk, B.M. and Fineout-Overholt, E. (2005). Evidence-Based Practice in Nursing & Healthcare: A Guide to Best Practice, Philadelphia, USA: Lippincott Williams & Wilkins. Meyer, J. (2000). Using Qualitative Methods in Health Related Action Research. British Medical Journal, 320: 178-181. Neville, C. (2005). Introduction to Research & Research Methods. Effective Learning Service, Bradford University School of Management, 1-45. Poggenpoel, M. and Myburgh, C. (2005). Obstacles in Qualitative Research: Possible Solutions. Education, 126(2): 304+. Samuels, S.W. (1997). Ethical and Metaethical Criteria for an Emerging Technology: Risk Assessment. Occupational Medicine, 47: 241-246. Schelbred, A. and Nord, R. (2007). Nurses’ Experiences of Drug Administration Errors. Journal of Advanced Nursing, 60(3): 317-324. Schneider, P.J., Pedersen, C.A., Montanya, K.R., Curran, C.R., Harpe, S.E., Bohenek, W., Perratto, B., Swaim, T.J., and Wellman, K.E. (2006). Improving the Safety of Medication Administration Using an Interactive CD-ROM Program. American Society of Health-System Pharmacists, 63(1): 59-64. Smensy, A.L. (2007). Barriers to Scholarship in Dentistry, Medicine, Nursing, and Pharmacy Practice Faculty. American Journal of Pharmaceutical Education. Thomson, R. (2007). Qualitative Research Study Design. Training in Research in Reproductive Health/Sexual Health Geneva 2007, 1-11. Von Krogh, G. and Naden, D. (2008). A Nursing-Specific Model of EPR Documentation: Organizational and Professional Requirements. Journal of Nursing Scholarship, 40(1): 68-75.                                                                                                   Credit:ivythesis.typepad.com

Critical Analysis of Published Literature

Critical Analysis of Published Literature Introduction Today, research in health sciences is important most especially th...

General HR practices and IHRM: The identical look in employee relations

General HR practices and IHRM: The identical look in employee relations               Traditionally, most Western-based ways of management adhere on the idea that people are identical, replaceable, and disposable things (Elkin and Sharma, 2007, 414). Today, more and more companies – both local and global – recognize the indispensable role of people as fuels of production and resource-based assets. As a result, it is necessary that people within businesses are handled using the most effective ways of management. The supervision of people is rooted on the principles and practices of business management and specifically assigned to one of its dimension called Human Resource Management (HRM). Most literatures (e.g. Burke and Cooper, 2004; Price, 2004; Sims, 2002; Schermerhorn, 2001) report that the general HR practices essentially revolve around the practice of recruiting, selecting, hiring, evaluating, training of employees that will fill in a vacant job position in a particular company and other similar activities, including devising the most suitable remuneration package, performance management, and managing conflict are among its other functions. Entrekin (2005) recognizes HRM as a crucial element in an organization’s life cycle. With the materialization of convergence in businesses and managerial functions due to globalization as well as technological developments, traditional Western and Eastern HRM practices expanded its area of coverage beyond given geographical locations (Von Glinow et al., 2002). It is necessary for people behind the global businesses to complement with these current changes (Alvesson, 2002). As a result, the concept of International Human Resource Management (IHRM) was introduced and put into theory and practice. This paper argues that there is no difference between general HR practices and IHRM. Using relevant body of literatures, the argument is supported by the idea that general HR practices are similarly adopted by international HR managers and leaders because they are basically using the general HR practices in managing a global workforce. In this discussion, it is assumed that the general HR functions are synonymous with local or domestic HRM.   General HR practices: the building blocks of HRM There is no difference between general HR practices and IHRM for the sole yet sufficient reasons that the latter (IHRM) uses the fundamentals of the former (general HR practices) in performing its planned tasks. Sims (2002) describes HRM as a business science that is predominantly concerned with all the activities of successfully attracting, developing, motivating, and maintaining a quality-performing workforce that is mutually geared towards organizational productivity and success. These HR processes are collective efforts in developing, enriching and maintaining of organizations’ capacity towards growth and development. The traditional characteristics of HRM include personnel managers who handle administrative tasks revolving around human resources planning; recruiting staff; job analysis; establishing performance review systems; wage, salary, and benefits administration; employee training; personnel record keeping; legislative compliance (affirmative action, EEO, etc.); and labor relations (Sims, 2002). Looking on the book authored by Schemerhorn (2001), there are three main HRM functions: attracting a quality workforce, developing a quality workforce, and maintaining a quality workforce. In a nutshell, attracting a quality workforce includes employee recruitment and selection process, developing a quality workforce includes employee training and development and evaluation, and maintaining a quality workforce include remuneration and pay systems, motivation and leadership, and labor relations. These are basically the general HR practices. An organization’s human capital and management philosophy must focus on recognizing the value of the workforce as assets who define organizational character and performance capacity (Champion-Hughes, 2001). Abramson and associates (2002) identify human capital as a critical factor that would either lead the organization to the path of success or failure. That HR practices, in this case, are expected to be executed accordingly. The effective application of general HR practices is associated to organizational performance and tantamount to organizational success. Treating people as assets motivate them to perform very well. The mere recognition of employees’ valuable contribution in production, and not just plain salaried employees, is good enough that they reciprocate by giving their best shots in maximum service and achievement of goals both on individual and organizational levels. Richard Pinola, chair and CEO of Right Management Consultants, Inc., has identified what upper management officials require from front professionals in terms of HR (Hornsby and Kuratko, 2005). To enhance real value to a company, HR must work in agreement with the organization’s overall strategy. When this approach is accomplished, affirmative changes can occur in talent management, leadership development, and organizational performance (Hornsby and Kuratko, 2005). Sambrook (2000) asserts that HRM plays a key role in leveraging the knowledge of the organization specifically in terms of enhancing employees’ core competencies. It is supposedly safe to consider a generalization that the description for HRM can only be established through the fulfillment of roles based on the needs and demands of the organization particularly on its employees. The effective implementation from the start up to the end will yield to higher employees’ productivity and increase in organizational revenues. All HRM functions should be deliberate and directed to the success of the organization.   International HRM: on using the general HR practices             Aside from the forces of globalization and technological innovations, the internationalization of businesses is among the underlying explanation in relation to the growing application of expatriates assigned to supervise increasing numbers of international operations (Bures and Vloeberghs, 2001). Meanwhile, Budhwar and Debrah (2001) notice a significant number of organizations that embark on significantly levering their HR policies and systematize them in new strategic directions. This is an apparent response to the global argument against traditional managerial beliefs, particularly of the West, concerning people’s treatment as mere ‘things’ by organizations for profitable and selfish interests. The change in HRM practices into IHRM is no exemption. Considering the growing demands of a global marketplace, the management of employees in a global working environment characterized by diversity and multiculturalism is crucial. This is the basic postulation of IHRM. International HRM is the management of people within a global setting. Peltonen (2006) provides a comprehensive definition of IHRM, which is “a branch of management studies that investigates the design and effects of organizational human resource practices in cross-cultural contexts” (523). Sims (2002) briefly explains that IHRM includes the “the process of procuring, allocating, and effectively utilising human resources in a multinational corporation” (360). The major distinction within HRM and IHRM is seen on the provision of organizational application with reference to geographic context. Most HR practices are relative and employed within domestic level. In contrast, several researchers (i.e. De Cieri et al., 2007, Evans et al., 2002; Schuler et al., 2002) argue that IHRM is intended for administering the added complexity in organizations as a result of diversity and multiculturalism among employees. Understanding employee diversity and multiculturalism in IHRM is important because such features affect overall business operations and human relationships. Although IHRM is uniquely identified with its provision to context and the added feature of diversity and multiculturalism among employees, it is still argued that there is no significant difference in terms of the general HR practices. International HR practices are still bounded within the standards of general (domestic) HRM.             To illustrate such claim, it is good to provide specific examples. General HR practices adhere to equal employment opportunity (EEO) in employee recruitment and selection (Daniel and Metcalf, 2001). International HRM practices similarly recognize EEO based on policies from main company headquarters. The EEO policies of international businesses are ensured to be in compliance with the legal requirements of both home and host countries. Dealing with national government authorities and other political figures plus a greater variety of socio-economic interest groups is useful. Traditional and general HR advocates are aware of the importance of fairness and equality in employee recruitment and selection. Both domestic and international HRM acknowledge that unfair hiring practices and insufficient understanding of EEO policies possibly will lead to charges against the organization requiring financial penalty. Other example is seen on employee motivation and compensation. The general HR practices believe on the concept of fair and competitive remuneration and pay systems for employees. Also, fairly and appropriately compensated employees are motivated to work more towards the advantage of the organization. According to the expectancy theory, employees expect rewards on the tasks they accomplished (Sims, 2002). This reward (e.g. financial and non-financial) will help them develop their individual work capacity and facilitate working up towards a higher level of skills competency. Generally, the compensation system tells employees which behaviors will be rewarded and which will be punished (Salas et al., 2004). General HR practices influence levels of motivation through the use of performance appraisals, pay-for-performance incentives, and internal promotions systems based on merit (Brown et al., 2003). In IHRM, fair and competitive remuneration and pay systems is also recognized with special consideration on the attribute of differences in currency. Sims (2002) says that HR managers and personnel need to reflect on the fringe benefits offered to host-country employees as these benefits may vary in significant aspects. On the aspect of employee evaluation, general HR practices are mainly reflected on overall performance of the organization. Evaluating employees’ performance has fared to satisfy the organization (Kamoche et al., 2003). Employee evaluation seeks to monitor and improve effectiveness by giving feedbacks on job performance and competency. This is a process that is carried out at regular intervals and follows specific protocols that support the concern of objectivity or fairness. The international workplace complements with this general HR practice of employee evaluation. Leadership is also considered as important features of both general and international HRM. Leadership is a behavior based on the elements of the leader’s personality (Santos and Santora, 2001). Chesser and colleagues (2001) declare that leadership is a key issue in the development of groups, organizations and nations. The leadership of every HR manager, domestic or international in duty, is based on the standard managerial functions. It caters on employee behavior and interaction. While general HR practices address common culture on the case of domestic HRM, IHRM practices consist of a wider cultural consideration. According to Hofstede (2001), the concept of culture at work is organizational in level. Whether in local or international context, extensive emphasis on culture is necessary and relies on the veracity that effective HR practices play an effective role on achieving high performance among employees.             Provided the above examples, there is indeed no difference between general HR practices and IHRM because general HR practices are adopted in international context. Although IHRM practices have special considerations, general HR practices govern its major functions such as the case of employee recruitment and selection, compensation and motivation, performance management and evaluation, leadership, and so on. The basic HR functions are generally used in both local and international working context. According to De Cieri and group, the general HR practices are integrated with in international working environment. There is integration in local and global aspects. Integration in general and international HR practices is important to every business organization (i.e. multinational companies) particularly in addressing issues on organizational conflict, contradictions, and business ethics.             Further, HRM will face both challenges and opportunities (Gross and Connor, 2007). General HR practices are the common denominator of both domestic and international HRM. Both environments use general HR functions in attending to the needs of the employees and the organization as well. Local and global HR managers must be able to acquire advanced knowledge on managing human resources. The developments affecting all employees in an organization can be used towards the individual and organizational advantages. People and organizations are said to be effective when they manage to provide the needed requirements expected from each of them. Generally speaking, the common HR principles and practices are generally accepted in all business setting. However, it is argued that some general HR practices are relative in some places and are integrated on current national workplace situation. The HR strategy of the organization should always be based on the recognition of the valuable contribution of employees to organizational performance and productivity. In sum, general HR practices are similar to IHRM provided that both uses the basic HR function in addressing the needs of the employees and the organization in balance and strategically designed ways.   References   Abramson, MA, Demense, RB, and Gardner, NW (2002) ‘The chained gang: Human capital management’, The Journal of Public Inquiry, Spring/Summer, 43-48   Alvesson, M (2002) Understanding organizational culture, Sage, London   Brown, MP, Sturman, MC, and Simmering, MJ (2003) ‘Compensation policy  and organizational performance: The efficiency, operational and financial implications of pay levels and pay structure’, Academy of Management Journal, 46, 752-762 Budhwar, PS, and Debrah, YA (Eds.) (2001) Human Resource Management in Developing Countries, Routledge, London Bures, AL, and Vloeberghs, D (2001) ‘Cross Cultural Patterns of Internationalization and Human Resource Management Issues’, Competitiveness Review: An International Business Journal incorporating Journal of Global Competitiveness, 11: 2, 48-56   Burke, RJ, and Cooper, CL (2004) Reinventing Human Resources Management: Challenges and New Directions, Routledge, New York   Champion-Hughes, R (2001) ‘Totally integrated employee benefits’, Personnel Management, 30: 3, 287   Chesser, J, Shah, A, Sterett, C, and Wilmore, J (2001), ‘Meeting the need for employee development in the 21st century’, SAM Advanced Management Journal, 26; 2, 22   Daniel, TA, and Metcalf, GS (2001) The management of people in mergers and acquisitions, Quorum Books, Westport, CT   De Cieri, H, Cox, JW, and Fenwick, M (2007) ‘A review of international human resource management: Integration, interrogation, imitation’, International Journal of Management Reviews, 9: 4, 281-302   Elkin, G, and Sharma, R (2007) ‘People, organisations and management: lessons for the industrialised world from the rest of the world’, Global Business and Economics Review, 9: 4, 395-416   Entrekin, L (2005) ‘Retaining core staff: The impact of human resource practices on organisational commitment’, Journal of Comparative International Management [online] (cited 21 April 2008) Available from http://www.allbusiness.com/management-companies-enterprises/1174466-1.html   Evans, P, Pucik, V, and Barsoux, JL (2002) The Global Challenge. Frameworks for International Human Resource Management, McGraw-Hill/Irwin, New York   Gross, A, and Connor, A (2007) ‘Understand Asia’s Uniqueness, HR Advised’, HR News [online] (cited 21 April 2008) Available from http://www.shrm.org/hrnews_published/articles/Articles%20TOC.asp   Hofstede, G (2001) Culture’s consequences: Comparing values, behaviors, institutions, and organizations across nations, Sage, Thousand Oaks, CA   Hornsby, J, and Kuratko, D (2005) Frontline PR: a Handbook for the Emerging Manager, Thompson, Crawfordsville, IN   Kamoche, K, Debra, YA, Horwitz, FM, and Muuka, GN (Eds.) (2004) Managing human resources in Africa, Routledge, London   Peltonen, T (2006) ‘Critical theoretical perspectives on international human resource management’ in Stahl, G. K. and Björkman, I. (eds), Handbook of Research in International Human Resource Management, Edward Elgar, Cheltenham, pp. 523–535 Price, A (2004) Human Resource Management in a Business Context, 2nd Ed., Thomson Learning, Chichester, UK Salas, E, Kosarzycki, MP, Tannenbaum, SI, and Carnegie, D (2004) ‘Principles and advice for understanding and promoting effective teamwork in organizations’ in Burke, R. and Cooper, C. (eds), Leading in Turbulent Times: Managing in the New World of Work, Blackwell, Malden, MA, pp. 95-120   Sambrook, SA (2000) ‘Talking of HRD’, Human Resource Development International, 3: 2, 159-178   Santos, JC, and Santora, JC (2001) ‘Leaders and values: a cross-cultural study’, Leadership & Organization Development Journal, 22: 5, 243-248   Schermerhorn, JR Jr. (2001) Management (6th edn), John Wiley & Sons, Inc., New York   Schuler, RS, Budhwar, PS, and Florkowski, GW (2002) ‘International human resource management: review and critique’, International Journal of Management Reviews, 4: 1, 41–70   Sims, RR (2002) Organizational Success through Effective Human Resources Management, Quorum Books, Westport, CT   Von Glinow, MA, Drost, EA, and Teagarden, MB (2002) ‘Converging on IHRM best ptactices: Lessons learned from a globally distributed consortium on theory and practice’, Asia Pacific Journal of Human Resources, 40: 1, 146-166         Credit:ivythesis.typepad.com

General HR practices and IHRM: The identical look in employee relations

General HR practices and IHRM: The identical look in employee relations Traditionally, most Western-based ways of manageme...

A Critical Review of One Key Reference Article: An Empirical Analysis of the Integration-Responsiveness Framework in Global Industries

A Critical Review of One Key Reference Article: An Empirical Analysis of the Integration-Responsiveness Framework in Global Industries   Contribution of the Article           Despite claims of existing literatures that in order for a business unit to function effectively, it must take on global competitiveness and sustain global attributes. However, the article emphasizes that a particular business unit can maintain and sustain a non-global competitive position in a global industry by focusing on competitive attributes that are directed towards the success and sustenance of a highly responsive local environment in which they operate. In addition to this, the article is important as it gives emphasis to the fact that quality customer service is the most important competitive attribute of any business unit.   Structure of the Article             The first part of the article is the article abstract, which presented the general topic to be discussed by the study. It also served to catch the attention and the interest of the readers in order to read and understand the rest of the article.             The introduction part of the article discussed the Integration-Responsiveness Framework briefly. This part also includes the main problem of the article, its purposes and the aims of the study. The next part is the theoretical background of the article, which discussed the IR framework as a model in relation to global integration. It also included the industry forces that influence the competitive structure of global industries. Lastly, it also included the concept of Business-level strategy and its role in strategic management. The next part is the research proposition, which emphasized on the different assumptions by the article. Such propositions are to be proven by the paper in the next part. Methods and Data include the sample, the measures, and the data analysis done by the article and its authors in order to come up with sound and relevant results and conclusions. The results and discussion part of the article discussed the findings of the article in three phases. In order to show and present the results or findings of the study effectively, several tables were presented. The implications and conclusion part of the study included the contribution of the article to the society and to practical situations. It also indicated what it wanted to impart to its readers. The different limitations of the study were also emphasized, including its recommendations as guide to future researchers.   Approach or Methodology             This study employed an exploratory research method, which involved three phases or steps, namely, the review of related literature of identified global industries, verification of 1 global competitor in the industry, and verifying the existence of high-level intra-industry trade. It also discussed the measures to be done, including the industry pressures, strategic variables, and performance. The data analysis done involved two phases, namely, the cluster analysis and the ANOVA analysis.   Key Findings             The first key finding of the study emphasized that although competing in global industries, businesses or business units have different perceptions in terms of its industry characteristics. Such differences are attributed to the different industry forces that confront each group.             The second key finding is that locally responsive businesses placed lesser emphasis on marketing differences compared to the global integration group and the multi-factorial business units.             The last key finding of the study is that all the three groups, namely, the global integration group, the locally responsive group, and the multi-factorial business units group showed no performance differences.   Weaknesses of the Article             One of the weaknesses of the article lies on the problems in relation to the availability, comparability, and reliability of secondary data, which excluded the examination of business units that are outside of the United States. The second problem is that this study focused only on business groups present in the United States.   Improved, Extended or Modified?             It can be stated that this particular study can be improved by studying other business units that can be found outside the United States. The study also mentioned that it used multiple methods in examining the different business units chosen for the study. However, such methods, given its multiplicity can be used to examine other global industries around the world. Thus, in this sense, the findings of the study can be more conclusive and generalized. In addition, the study can be improved by exercising care in generalizing the findings of the study beyond the US context.      References Jackson, T.H., (2002). International Hrm: A Cross-Cultural Approach. London: Sage Publications Ltd. Katsioloudes, M.I. and Hadjidakis, S., (2007). International Business: A Global Perspective. Burlington, MA: Elsevier, Inc. Mellor, R., Hettihewa, S. and Batten, J.A., (2006). “The Relationship between Firm Management and the Ethical Practices of the Firm: Australian Evidence”. The Journal of Corporate Citizenship. Partington, D. (2002). Essential Skills for Management Research. London: Sage Publications, Ltd. Roth, K. and Morrison, A.J. (1990). An Empirical Analysis of the Integration-Responsiveness Framework in Global Industries. Journal of International Business Studies, 21(4): 541-564. Credit:ivythesis.typepad.com

A Critical Review of One Key Reference Article: An Empirical Analysis of the Integration-Responsiveness Framework in Global Industries

A Critical Review of One Key Reference Article: An Empirical Analysis of the Integration-Responsiveness Framework in Global Industries ...