1. Was there a clear statement of aims of the research? Yes, the aim is clearly stated in the essay, “This study aimed to explore the lived experience of sub-fertility among Chinese couples in Hong Kong. ” (Loke, Yu, Hayter ). The population of the research is the couples that without children even if they tried. The research investigates their feelings and experience by interviews in 5 months, from August 2003 to January 2004. 2. Is a qualitative methodology appropriate?
Yes, this study uses phenomenological approach which can reflects one’s experience and feelings( Parahoo 1997) as the frame of the design of this research, this can logically making abstract materials into qualitative data for a research. Since quantitative research aims of numerical and accountable result (Denzin, Lincoln  ), it is not suitable to use quantitative approach to investigate feelings and experience. 3. Was the research design appropriate to address the aims of the research?
Yes, since the research aims to study the experience of sub-fertility of Chinese couples, the design is using phenomenological approach such as interviews, conversation and participants observation to those “involuntary childless” couples (Loke, Yu, Hayter ) which is for the aim of the research. By recording the interviews during conversation and interpreting the facial expression, general feelings of the participants can be transcribed. (Collazi ) 4. Was the recruitment strategy appropriate to the aims of the search?
In the research, a “snowballing sampling technique “ is used (Loke, A, Yu P, Hayter M (2011) which means the initial group of contacts are friends of the researcher, then by using their network, this research and recruitment information are spread out and interviewees are then found. This strategy has no conflicts with the aims of this research because the potential interviewees are further selected after a fully explanation, so the interviewees in the study are screened to fit for the aim of the study.
However, the research team can consider finding some more significant participants in hospitals, communicate with fertility clinic to get a bigger pool of participants so that the result can be more significant. There are 2 disadvantages of ‘friends and friends of friends’ approach, first, the pool size is limited. The second one is, some infertility couples may not want friends to know or involved in the issue, they may feel embarrassed to tell others.
Unlike those infertility couples in fertility clinic, they are comparatively more open-minded to their issue since they are willing to seek for help, they are more willing to share their thoughts, difficulties and worries. 5. Were the data collected in a way that addressed the research issue? Yes, since the aim of the research is to investigate the feelings of the sub-fertility among Chinese couples in Hong Kong, the data are collected by interview of target group, not only record the conversation, but also the gestures, facial expression and even tone of voice.
These are features of one’s reaction expressing feelings and experience, so it addressed the research issue. 6. Has the relationship between researcher and participants been adequately considered? To avoid subjective opinion or bias affecting the researching result, the researcher should be unknown to each other. The recruitment method as mentioned above was first started from friends of research. By reflexivity of a qualitative research, which means the thoughts or ideas of the researcher through the research(Mruck, K. & Breuer, F.
) , since there is none further explanation on the relationship of the participants and the researcher, which means some of the participants may be direct friends of the research which may cause some bias based on the experience they had. For example, if one pair of the participants are an old friend of the researcher, this pair may not willing to open their private issue to this old friend, still, they would like to help for the research, or on the other hand, the researcher may have a subjective opinion based on his perception to this pair old friends, as a result, the result may have false based on 2 way.
1. Hidden information from interviewee to interviewer or 2. Misinterpret the conversation on the interview by the researcher. The research has not enough consideration and explanation. 7. Have ethical issues been taken into considerations? Yes, the researcher has got the ethical approval from the Hong Kong Polytechnic University’s ethical committees before the study. The participants were explained fully and the interviews are recorded. Confidentiality is also guaranteed. The participants can also leave the research whenever they want, so they are not forced to be interviewed, giving false answers.
8. Was the data analysis sufficiently rigorous? The method of data analysis is clear, with deep explanation of colazzis approach. However, there are 3 points that making the data analysis with bias and not enough supportive. First, here are only 4 couples and 3 women were interviewed, which means only 7 women and 4 men has shared their feelings, this number is small and how they expressed may not be significant to represent the whole picture of the Chinese couples in Hong Kong.
Also, since the researcher has put the different feelings into difference categories, with small number of data collected, supports are even more little in each categories. Second, since the interviews were first transcribed into audiotapes and then translated to English from Chinese. During transcription, some points may be missed due to device fault or auditory error. During translation, the meaning can be difficult to direct translate from Chinese to English with different cultural background and wordings.
Finally, in the data analysis, there are no contraindicating data provided by the interviewers, the researcher did not mention whether there are no opposite comments or deducted from the analysis, making this research one-face-down. 9. Is there a clear statement of the findings? Yes, the findings are explicit, the researcher has used 7 paragraphs in the discussion part, indicating 7 lived experience of the Chinese couples in Hong Kong. The discussion is adequate, full of supporting materials and references.
The area of discussion were multi-level, from psychological (like guilty, ashamed), to physical (like unwilling to talk about this event, refuse to gathering), and from sociological (like concerning the financial burden and ‘assurance’) to cultural ( the believe and view of traditional Chinese to fertility and offspring development) However, since there are only 4 couples and 3 women were interviewed, the number of data is small, and not significant enough to represent the overall Chinese couples in Hong Kong. 10. How valuable is the research?
This research can help improving the understanding of the experience of those sub-fertile couples which can also help the healthcare professionals to have a better picture of their psychological need. Also, the researcher has compared the findings of this research and other studies among Chinese couples, they found that the results were similar, indicating that Hong Kong couples are not unique. This finding can help to improve the communication of the healthcare professionals of China and Hong Kong. Paper 2 For qualitative research, A randomized trial of nursing intervention supporting recovery of the postmastectomy patient.
(Cho, H. S. , Davis, G. C. , Paek, J. E. , Rao, R. , Zhao, H. , Xie, X. J. , Yousef, M. G. , Fedric, T. , Euhus, D. H. , & Leitch, M. ) would be used. 1. Did the trial address a clearly focused issue? Yes, this trial has addressed a clear focus issue. Which aims to investigate how the Papilla Gown and education of preparation of post-operative care can improve the activity limitation (A), issue of body image (B), and comfort issues (C). The research compare the outcome by dividing the candidates into 4 groups. 1. Provide gown but not education, 2. Only education without gown, 3. Both without gown and education and 4.
With education and gown in 1 week and 6 months after operation. 2. Was the assignment of patients to treatments randomised? Yes, the patients are randomized by picking colour straw to the treatment. Randomisation can eliminates bias in treatment assignment, “Comparisons of different forms of health interventions can be misleading unless investigators take precautions to ensure that their trial comprises unbiased comparison groups relative to prognosis, in controlled trials of prevention or treatment, randomization produces unbiased comparison groups by avoiding selection and confounding biases.
Consequently, comparison groups are not prejudiced by selection of particular patients, whether consciously or not, to receive a specific intervention. ” (Schulz, K. F. & Grimes, D. A. ) 3. Were all of the patients who entered the trial properly accounted for at its conclusion? Yes, by intention-to-treat analysis, “Includes all randomized patients in the groups to which they were randomly assigned, regardless of their adherence with the entry criteria, regardless of the treatment they actually received, and regardless of subsequent withdrawal from treatment or deviation from the protocol” (Fisher, L.
D. & Dixon, D. O. ). Although some of the participants have failed to proceed to the end due to several reasons like death and missed clinical appointment etc. Still there are numbers of participants at the end and give a conclusion to this research. 4. Were all of the patients, health workers and study personnel ‘blind’? The patients and the study personnel were not blind. Each group of patient receiving different treatments are told and explained before they participate the research, and the research personnel knows the group the patients were in.
Blinding is a method to avoid bias from the researcher or participants. For example, when there are two different drinks with similar taste, to test which taste better. To avoid bias from the colour or other characteristic of the drinks, participants need to be ‘blind’, by covering eyes, and taste the two drinks, and find out which taste better. This is a single-blind test. However, in this research, both the researcher and the participants know which group they are in, they know what they are going to do and wear before the research started, so they are not ‘blind’.
It is, however, possible to make the participants ‘blind’ if the researchers just need to tell the candidates that they are going to have a survey on the post-surgery result without informing them that some of them need to wear special gown but treat it as usual practice of post-surgery care. When the ‘experimental’ group does not know they are using a new device, their feelings may be different as some of the candidates may think new device must better or some of them may think new device need a lot of improvements to be perfect. Tese thoughts may adjust their subjective feeling to the result. 5.
Were the groups similar at the start of the trial? There are selection criteria of the selected patients, such as, must be female patient aged 18 or above, diagnosis of stages two or three breast cancer with axillary lymph node dissection, ability to read, understand and communicate in English, and had planned a total, modified radical or radical mastectomy with the use of a drain, which makes their background similar. By making the participants into a similar group, the researcher can be able to quantify the impact of the intervention of the study, with least effects from other factors that are not related to the study. (Jadad, A. R.
) For example, if there is a research comparing jogging and weight bearing exercise to the effect of weight lost, the participants should be in similar life-style, to exclude the effect from big eaters or health status. 6. Aside from the intervention were the groups treated equally? Yes, the groups are treated equally to prevent bias. 7. How large was the treatment effect? The effect of the treatment consisted of 5 parts: Activity, Body image, Comfort, Cancer Knowledge and Lymphoedema. For Activity, the PAS score (an instrument to measure activity level objectively), increased significantly with 95% confidence interval and p-value < 0.
0001, which shows a very significant effect. To patient who wear gowns and who not wear gowns, the p-value is 0. 039, which also shows a significant result. However, there is not much effect on PAS score of the groups of education and not education. For Body image, there is no main effect with BIS (an instrument to measure change of body image objectively of the patient) For Comfort, the result is very significant, patients who wear Papilla gown, the PMGCI (an instrument to measure comfort) compared to those who wear general hospital gown, the p-value is 0. 0001 with both CI 95%. Although the p-value is also