NUR 2300: Awakening: A Qualitative Study on Maintaining Weight Loss After Bariatric Surgery - Nursing Assessment Answers

January 14, 2018
Author : Julia Miles

Solution Code: 1AEJC

Question:

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To conduct a critique of a research article, use the three steps of the critique discussed in the Assignment 2 Powerpoint and Learning Activity guide for each of the following sections of the research report article.

  1. Literature review/theoretical framework
  2. Research topic, phenomenon of interest, research question or hypothesis
  3. Research method
  4. Data collection methods
  5. Data analysis
  6. Findings

      • Requirements are clearly laid out in the qualitative and quantitative rubrics for the assignment.
      • It is always a good strategy to use the outline of the rubric as an outline for your assignment and to keep comparing your assignment to the rubric as you are writing each section.
      • Don’t forget to submit an electronic copy pdf file of the article with your assignment as an Appendix.

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Solution:Article “Awakening: A Qualitative Study on Maintaining Weight Loss AfterBariatric Surgery”

Focus

In this article, the topic of concern is finding out the experiences of obese adults after undergoing successful Bariatric surgery by maintaining weight loss based on a qualitative approach (Palou & Bonet, 2013). The measurable variables that can be identified in the researcher’s statement of this article include weight loss, age, ethnic group, education, height, sex and social class. These measurable variables are important for the researcher’s statement since it helps the audience of the article to get a full insight of what was measured when the study was being conducted. The reader finds it easy to follow the obesity discussion (Fontaine, Williams, & Hoenemeyer, 2016).

Background

The researcher of this article argues that the topic is actually worthwhile. This is because the focus of the study is about the expectations and experience. For instance, sustained weight loss have been established to occur due to Bariatric surgery (Busetto, 2015). In addition, patients’ have been shown to improve in relation to quality of life and psychological morbidity. The topic also encompasses the mechanisms behind Bariatric surgery success as well as examining the likelihood surgical operations, improving the health status of an obese Bariatric. According to the researcher the loss of weight by other methods may result in weight gain as compared to weight loss after Bariatric surgery. The researcher also argues that little research have been conducted even though it has been established that maintenance of loss of weight starts two years after Bariatric surgery. He also holds the opinion that obesity is a big problem that has affected the human race all over the world. It is worth to note that the seriousness of this topic as chosen by the researcher is reinforced by previous studies. For example, in the introduction the researcher explicitly explains that much research on Bariatric surgery over the past decade have been published (Sencan, Utku, & Gokce, 2015). These past publications focus on assessment of the Bariatric surgery effectiveness. In these past publications, the researcher outline that the results of obesity surgery have shown positive weight loss as well as improved weight loss maintenance. However, the researcher elaborates that Bariatric surgery has no negative effect on weight. Further research has looked at postoperative changes in relation to the individual patient’s health status, eating behaviour, psychological morbidity as well as quality of life. This article has shown thorough literature review of current knowledge related to this topic (Stein, Stier, Raab, & Weiner, 2014). For example, De Zwann et al (2002) was reviewed by the author to show the quality of related to health as seen in obese patients. The emphasis of this paper was the impact of surgical operation in the gastric. Secondly, Karlsson et al (2002) was cited by the author in reference to quality of life and health-related issues as well as the eating habits of a patient who has undergone Bariatric surgery particularly in severe obese situations. In this article there is no definition of key variable, but there is an attempt made on how the variables are measured. For example, a questionnaire was used to fill in the variables (Kayyali & Rosenberg, 2012).

Methodology or broad approach

The broad approach or methodology used in this paper was a qualitative design. The use of qualitative design was to provide a deep understanding of maintaining loss of weight after Bariatric surgery. In this research, the Social Cognitive Theory used to be Bandura’s. It provided the framework for conducting semi-structured interviews for the qualitative descriptive research. The qualitative data included age and height apart from weight loss. These were measured and took the form of numerical. Other qualitative variables that were measured included ethnic group, education, sex and social class (Sencan, Utku, & Gokce, 2015). The qualitative data focused mainly on the characteristics and the data could not be quantified. Therefore, the use of qualitative approach matches the statement of the objective.

Tool of data collection

The method used for data collection in this article was basically done using a customized questionnaire. Customized questionnaire is a data collection tool that has been used for a long time in many research. It basically categorizes variables into groups that are relevant to the study. Being a qualitative tool in this study, there was no essence of piloting. In the literature review section, the researcher has indicated that there were two previous research that engaged the use of this kind of qualitative tool. However, these two previous studies basically focused on the surgery impact on the quality of life rather than looking at the broader picture are captured in this study. The mentioning of these two previous studies that were rather similar to this study gives credibility to the study (Chiappetta & Theodoridou, 2015). This is because the researcher of this study is giving a clear and precise details on the environment and the circumstances in which data collection took place. This study was actually conducted in a hospital set-up. Therefore, I feel that this qualitative tool was effective since interviews were conducted in a relatively serious hospital environment where patients are less likely to give false information. It is important to note that the hospital where this study was conducted has a multi-disciplinary obesity program that follow-up the obese patients for normal assessment and educate them on weight loss management. This made it easy to administer the questionnaires. In fact, questionnaires were given to all the patients under investigation. The highest score in the questionnaire reflected an improved health or greater health status.

Methods of data analysis and presentation

Data analysis and presentation is key to any qualitative approach. The researcher has to analyse data and present them in the simplest form possible that can be interpreted and understood by the audience or reader of the paper. In this article, data was analysed using the Statistical Software for Social Scientists. The software analysed the data by making a comparison of surgery group profile features, experiences of eating, current BMI as well as health status with waiting list controls. Z-score (?2) was chosen for the analysis. To check the homogeneity of variance, Levene’s test was used. The reported P-Value was P<0.05 while the confidence interval was 95%. This shows that the analysis targeted at presenting an accurately presented data with limited room for doubts. It is worth to note that researcher used a relatively large amount of data so as to reduce biasness (Berthoud, Shin, & Zheng, 2011). The analysed data were presented using tables such as the participant weight and surgical information table on page 955 of the article. This profile characteristic table is simple and easy to understand even though it is both implicit and explicit.

Sample

As described earlier, the hospital where this study was conducted has a multi-disciplinary obesity program that follow-up the obese patients for normal assessment and educates them on weight loss management. This made it easy to administer the questionnaires. In fact, questionnaires were given to all the patients under investigation. The highest score in the questionnaire reflected an improved health or greater health status. The data in this article were collected on the basis of experience of eating. The researcher explains that according to the literature, there are some side-effects of obesity surgery. Therefore, based on such literature, patients were requested to give their views on eating either negative or positive using five-point Likert scale. The Likert scale ranged from 1 to 5 or “not at all” to “totally agree” respectively. This is in line with many other research that have used a similar approach in data collection and analysis. Nine participants were subjected to RYGB, four were subjected to LAGB and one LSG. The patients were actually asked what they had eaten over the last one month and to what extent did they feel about a series of items (Ciangura & Corigliano, 2012). The average weight before surgery was 313 pounds at SD=96. On the other hand the negative experiences included the desire to get sick, overfull and nauseated (SD=96). This kind of sample analysis is found in most scientific work related to obesity.

Ethical considerations

The researcher got approval from the institutional review board of the University. Moreover, every participant had a written consent before taking part in the interview. This is a mandatory requirement by most national government globally. The study was conducted in London and the UK government has mandated laws on scientific research.

Conclusions

The measurable variables that can be identified in the researcher’s statement of this article include weight loss, age, ethnic group, education, height, sex and social class. According to the researcher obesity as a problem is widespread globally and is one of the leading public health concerns. The researcher argues that everyone starting from childhood to adulthood is susceptible to abnormal weight gain due to lifestyle and eating habits. It is a big problem that has affected the human race all over the world. It is worth to note that the seriousness of this topic as chosen by the researcher is reinforced by previous studies. For example, in the introduction the researcher explicitly explains that much research on Bariatric surgery over the past decade have been published. The qualitative data focused mainly on the characteristics and the data could not be quantified. Therefore, the use of both qualitative and quantitative approach matches the statement of the objective. The method used for data collection in this article was basically done using a customized questionnaire. Customized questionnaire is a data collection tool that has been used for a long time in many research. In this article, data was analysed using the Statistical Software for Social Scientists. The software analysed the data by making a comparison of surgery group profile features, experiences of eating, current BMI as well as health status with waiting list controls. Z-score (?2) was chosen for the analysis. To check the homogeneity of variance, Levene’s test was used. Nine participants were subjected to RYGB, four were subjected to LAGB and one LSG. The patients were actually asked what they had eaten over the last one month and to what extent did they feel about a series of items (Ciangura & Corigliano, 2012). The average weight before surgery was 313 pounds at SD=96. On the other hand the negative experiences included the desire to get sick, overfull and nauseated (SD=96). This kind of sample analysis is found in most scientific work related to obesity.

Recommendations

It will be important to expand this obesity surgery research to encompass health care workers and assess their perceptions on the patients’ expectations, recovery path as well as weight-related stigmatization. The research should also include the views of healthcare workers in post-Bariatric surgery. Moreover, the research should be repeated in a different hospital environment following the same procedure but with different experimental units. This will allow for the validation of the data

Overall strengths and limitations

  • One of the major strengths of this study is the use of technology known as photo-voice. These photos-voice triangulated photographs in conjunction with the interview. This kind of combination can be applied to conduct research with other teams where acquiring in-depth evidence can be challenging. For example, in situations where trust is required to be built among research participants who may probably feel socially isolated, especially when the topic of study is very sensitive.
  • Another strength of the research is that the sample contained 131. This allows for the data to be analysed to be considered credible and valid.
  • The limitation of this study is that the participant/ patient were recruited from one single hospital. The patients seeking treatment at the hospital are few and may not be representative of the entire population. It would have been good if the research could have expanded to engage at least two hospitals with a relatively high number of patients.

Application to practice

Bariatric surgery may be applied in most cases of obesity conditions. As have been discussed in this critical analysis of the article above, quantitative research supports obesity surgery in the sense that the surgery is accompanied by elevated negative experiences normally after eating like fullness and nausea as well as improved health status. Therefore, in severe cases of obesity, Bariatric surgery would be the best option to improve on the health of the patient (Liebl, Barnason, & Hudson, 2015).

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