Research Article Appraisal Assignment Paper

Research Article Appraisal Assignment Paper

Legal & Ethical Issues

1. Briefly discuss institutional review board approval for the study.

Intanai el. al. (2022) was approved by the human research ethics committee of the Faculty of Medicine Ramathibodi Hospital, Mahidol University (CA.MURA2021/655). It was also approved by the Human Research Ethics Committee Bangkok (U018h/64)Research Article Appraisal Assignment Paper.

2. Explain how ethical principles of research (beneficence/harm, justice, privacy, and autonomy) were followed to protect subjects if that was explained or implied.
   

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The ethical research principles of privacy and autonomy were followed. The principle of autonomy was maintained by informing the participants of the research on the research objectives. The authors also informed the participants of the data collection procedures and the duration of the research. The participants were also informed of their rights to refuse to participate in the research without repercussions on nursing care. The principle of privacy was followed by ensuring the participants that the data collected from them would be kept confidential and would be reported as group data to maintain anonymity.

3. If the study included subjects from a vulnerable population as described in the textbook, describe any additional safeguards used to protect them.

According to Gray and Grove (2021), vulnerable populations in research are the participants who the research may harm. Vulnerable populations often require compensation. However, the research did not involve any vulnerable populations, so no additional safeguards are mentioned.  Research Article Appraisal Assignment Paper

Measurement Tools

Fill out the table below for the major variables in the study (NOT demographic variables).  You can add rows as needed, depending on how many measurement tools were used.  Boxes can be expanded for more content.

Name of Tool (Author, year)	Level of Measurement	Reliability reported	Validity reported
Bilirubinometer	The ratio level of measurement is used.  Therefore, the bilirubin results in the study were displayed in mg/Dl.	Regular calibrations maintain the reliability of bilirubin meters. The company servicing the device conducts monthly calibrations to ensure the measurement tool’s reliability.	Regular calibration also supports the validity of the bilirubin meter, ensuring the tool’s accuracy in readings.
Infant Massage, Feeding, and Excretion Record Form	This tool’s measurement level is the ranking of the frequency of massage, feeding, urination, and defecation.	Even though the tool’s reliability is questionable, considering it depends on the mothers’ self-reporting	The tool’s validity depends on the mother’s understanding of recording the data correctly. Using predesigned forms, however, increased the tool’s validity.
Bilirubin Levels and Re-hospitalization for For Hyperbilirubinemia, record Form	The bilirubin levels are measured in mg/dl, while rehospitalization is a nominal variable.	The tool is reliable because the primary investigator recorded the data at intervals of 6, 48, and 96 hours to ensure consistency and data accuracy.	The validity of the data collection process is enhanced by the structured follow-up using the LINE app, ensuring that re-hospitalization data and bilirubin levels are collected systematically.

 

Data Collection

1. Describe the data collection procedures described in the study. Include who collected the data, at what time points, and how data was collected. Evaluate how clearly and completely the procedures were described.

The primary investigator collected all the data in the study between June and August 2022. Following approval from the IRB, the primary investigator met with the head nurse at the study setting and clarified the research purpose, requesting support and cooperation in the data collection process. The primary investigator then recruited the infants and their mothers and collected the data. The mothers in the experimental group were taught to massage the infants. In addition, data was tracked using the LINE smartphone application. Research Article Appraisal Assignment Paper

2. If more than one data collector was used for the study, describe the training of the data collectors and how/whether interrater reliability was adequately assessed.

The study only had one data collector, the primary investigator. Therefore, there was no need to train other data collectors or assess interrater reliability.

Data Analysis

1. List the statistical procedures performed to describe the sample or demographic variables.

The statistical procedures that were performed in the study to describe the sample and demographic variables were descriptive statistics, independent t-test, chi-square, and Fisher’s exact test.

2. List the statistical procedures performed to answer the research question(s) or main study variables. Research Article Appraisal Assignment Paper

The statistical procedures used in the study to answer the research questions and study variables are repeated measures ANOVA, which assessed the differences in bilirubin levels between the experimental and control groups, and Fisher’s exact test, which compared the differences in the rate of re-hospitalization for bilirubinemia between the two groups.

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3. Discuss the appropriateness of the statistical procedures for the level of measurement of the data collected. Utilize the statistical decision tree in the textbook, Chapter 21, Fig.21.7.

Several factors are involved in determining the suitability of a statistical procedure for a study, including the nature and purpose of the study, hypotheses, objectives/questions, experience in statistical analysis, and availability and access to statistical software (Gray & Grove, 2021). Based on these factors, the statistical procedures were appropriate for the level of measurement of the collected data. For instance, descriptive statistics are appropriate whereby the nature of the study includes categorical and continuous data, and interval/ratio level data, just as in this case. The independent t-test was also appropriate for comparing two independent groups, such as the experimental vs control group, and therefore, it was appropriate for this study. Research Article Appraisal Assignment Paper

 

4. Describe how the researcher(s) addressed any problems with missing data if they did.

There was no missing data in the study. Therefore, Intanai et al. (2024) do not mention problems with missing data and how they would have been addressed.

 

5. Describe the level of significance (alpha) set for this study.

The level of significance (alpha) is the threshold set by researchers to determine whether the results of a statistical test are statistically significant. The level of significance (alpha) set for this study =0.05. A 0.05 significance level implies a 5% chance of making a Type I error, and the study accepted a 5% risk of falsely detecting a difference between experimental and control groups.

 

6. Discuss the clarity of the presentation of study results (e.g., if tables or figures were used, clear description, etc.)Research Article Appraisal Assignment Paper.

This article clearly presents the study results. Tables compare demographic characteristics, daily defecation, and urination frequency between the experimental and control groups. Repeated measures of ANOVA comparisons of the mean bilirubin levels and the mean difference between the experimental and control groups were also tabled. A figure is also included to show the mean of bilirubin levels.

Researcher Interpretation of Findings

1. Describe the key findings of the study in relation to the purpose statement or hypotheses.

The key findings in the study are that the infants who received the massage had significantly lower mean bilirubin levels than the ones in the control group. Additionally, there was no difference in rehospitalization with bilirubinemia between the groups. In addition, the frequency of defecation on the first and fourth days in the experimental group was significantly greater than in the control group, indicating that mothers’ infant massage can help reduce bilirubin levels in full-term infants. Research Article Appraisal Assignment Paper

2. Evaluate the clarity of the authors’ explanation of key findings, including statistically significant & non-significant findings.

The authors have clearly explained the study’s key findings, including statistically significant and non-significant findings. For instance, they mentioned that there were no significant differences between participants’ demographic variables despite being statistically non-significant. The statistically significant findings have been presented individually for more clarity.

 

3. Discuss whether the key findings were clinically significant or clinically important.

The key findings were clinically significant and important. Considering hyperbilirubinemia is one of the major concerns among infant populations, the study findings aimed to address the issue. The findings hold promise for nurses to integrate infant massage in training mothers at an early stage after birth for the prevention of hyperbilirubinemia in new-borns infants, hence clinically significant and important. Research Article Appraisal Assignment Paper

4. Describe which findings were consistent with those expected, and any which were unexpected in your opinion.

The findings on the differences in bilirubin levels between the control and experimental groups were consistent with my expectations, considering the participants from the experimental group received the infant massage while the control group did not. However, I did not expect that there would be a significant difference between the daily defecation and urination frequency between the experimental and control groups. However, the overall findings were consistent with my expectations.

5. Describe the implications for practice identified by the authors.

The study’s implications for nursing practice include that infant massage should start at an early stage after birth, six hours after birth, and be performed twice daily for 15 minutes each for four days. In addition, the practice could be included in routine new born nursing care to reduce bilirubin levels and neonatal jaundice.

6. Summarize the suggestions for future studies (research) identified by the authors.

Further research is recommended using the different massage patterns from this research, including different massage techniques, durations, and massage therapists to increase the efficiency of reducing bilirubin levels.

Overall Evaluation of the Entire Study

1. Discuss two strengths of the study.

The study’s major strength is that the primary investigator is knowledgeable about new born nursing care and, therefore, was able to train the mothers on infant massage appropriately. Also, there was only one data collector, the primary investigator, hence no need for interrater reliability. In addition, the quasi-experimental study used an intervention and control group, hence the ability to provide quality and applicable results. Research Article Appraisal Assignment Paper

2. Discuss two weaknesses of the study and how each weakness could have been corrected.

The study could not record the amount of milk received by the infants, and when the infants were discharged, they were not weighed at home. Therefore, these factors could have affected the consistency of data collection. Another study’s weakness is that bilirubin levels were induced by newborn physiology, and the findings cannot be utilized as a guideline for newborns with pathological jaundice.

3. Based on the previous research presented in the literature review and the study’s findings presented in this article, discuss whether the findings are ready for use in practice.

Infant massage shows promise as a non-invasive and effective intervention for reducing hyperbilirubinemia in newborns. However, its use in practice should be considered within clinical guidelines, ensuring that healthcare providers are well-trained and that further research supports its efficacy across various populations and settings. While it may not be ready to replace established interventions like phototherapy, it could be an excellent complementary therapy with minimal risk and cost-effectiveness. Research Article Appraisal Assignment Paper

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Reference List

Gray, J. & Grove, S. (2021). Burn’s and Grove’s The practice of nursing research: Appraisal, synthesis, and generation of evidence (9th ed.). St. Louis, MO: Elsevier. ISBN 978- 0-323-67317-4

Intanai, N., Daramas, T., & Patoomwan, A. (2024). Effects of mothers’ infant massage on bilirubin levels and re-hospitalization for hyperbilirubinemia: A Quasi-experimental Study. Pacific Rim International Journal of Nursing Research, 28(3), 676-688. https://doi.org/10.60099/prijnr.2024.268257 Research Article Appraisal Assignment Paper