Hospice Caregivers

Evaluating the Research Process

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Abstract

Hospice is a comfort medical facility that takes care of a person at the end of his or her life. It aims not at treating a condition, but ensuring that the person or patient is comfortable and is in a positive environment. Hospice approach to the medical care involves providing support to the informal or unpaid home caregiver and the family. This allows the recipient to die at home or in a homelike setting with dignity. However, hospice has been mentioned severally because of its perceived role in teaching, supporting, and creating awareness among the informal or unpaid caregivers. Hospice has been thought of as failing to provide appropriate information to caregivers especially on the issues relating to medication. It is for this reason that Joy and Lau undertook a research on the same. This paper reflects on the whole issue of hospice as presented by the two authors/researchers.

Evaluating the Research Process

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How Is the Literature Review Used in This Tesearch?

Joyce and Lau have used literature review as an evaluative report of the studies related to their research. They have provided literature review to summarize, describe, evaluate, and clarify their research topic. They have considered the perilous ideas of the current data including practical results as well as the methodological and theoretical contributions to their topic of study. They have utilized secondary resources to report previous researches and findings. Mainly, the two authors have used literature focused on their area of study. In doing so, they have been able to appraise their study by selecting and synthesizing high value study evidence pertinent to the subject of study. While doing literature review, the authors have gone beyond the point of searching for information and included the identification and articulation of the relationship between their topic of research and that of the works being reviewed. Also, literature review has been utilized in this article to enhance research justification.

What are Ethical Considerations for Data Collection?

The data gathering process of this study was suitable, because it was in the form of an interview. A total of 97 hospice providers of different disciplines were interviewed to get their opinion on the experience and challenges they faced and see whether they had any problems in managing the drugs they administered to their patients. In the case of this particular study, the last names of the hospice providers were not revealed. Information about where they worked or lived was also not released. However, only name and age was given where necessary. During the collection of data, a research assistant was also present. His role was to clarify the survey items and ensure 100 % response among the interviewees. In addition to this, he considered an ethical aspect by ensuring that attendants did not share answers. Sharing of answers by attendants would jeopardize or negatively influence the research findings. The authors also observed objectivity vs. objectivity. They had no personal biases while conducting the research. They gave all informants involved a fair chance to provide information without soliciting. The authors did not also take advantage of easy-to-get informants. They chose their subjects in a process that was very beneficial to the research.

What Is the Data Telling Us in Terms of Statistical Analysis?

The data was collected through interviews; then these interviews were entered into tables to be analyzed as percentages. The percentage was then assessed to show if the caregiver has problems with managing medication. Since the findings are in figures, the analysis process is appropriate for the data collected. The method used calculation and comparison. The analysis method of this study included calculation and comparison. The procedures are appropriate for answering the question about the ability of caregivers to alleviate the suffering of hospice patients. The analysis methods used in this study reveal the knowledge of the caregivers. Qualitative data are associated with the expression of feelings, thoughts, and behavior of a person while quantitative data relate to pure science, experimental research, and methodology. Qualitative information or data are information that deals with explanations. Qualitative data cannot be measured whereas quantitative data are measurable and are mostly in numbers.

Are the Findings Statistically Significant?

Statistical significance tries to find if the differences among the groups or hypothesis studied are real or simply accidental. Among respondents, 67 % ranked ensuring appropriate medication administration among caregivers as the most important for the hospice services delivery. Important rankings varied significantly as p= 0.027; this shows that statistical significance was quite low. Overall, 33 % of caregivers had very frequently or frequently encountered the problems of managing medications. These percentages varied by professional discipline (p=0.001); again, the statistical significance was very low. In order to support the validity and reliability, the instrumental tools used in this study were the interviews with open-ended questions. Open-ended questions eliminate the need for the yes or no responses; instead, they encourage the subjects to open up more revealing their feelings and telling about what they think and their positions in other aspects that might be relevant to the study. This insight gives the interviewer a better understanding of what these hospice providers go through in their duties. It is important to the study, because it provides the insights of the hospice providers. This study is done to assess the knowledge, methods, and challenges of hospice providers in managing medications for home hospice patients so as to support them in their service delivery. More specifically, the study assesses methods to determine whether hospice caregivers have problems with managing medications.

Do the Conclusions Match the Results of the Study?

The findings of this paper show that hospice providers play an important role in helping caregivers in their various responsibilities including medication management. Medication management in home hospice patients is paramount, but is yet to be fully arranged. It can be made successful by formulating agency policies to improve medication management. Hospice providers also believe that more funds should be given to them to assist them address caregivers with matters related to medication management. Finally, more intervention techniques have to be put in place to improve the quality of home hospice care worldwide.

This study used scientific methods in data collection and analysis. The strong point of this research or investigation is that the data were collected directly by interviewing the respondents. Direct assessment of the caregivers by asking them to demonstrate some techniques, for example, to administer liquid medicine is also an important aspect in this study. Findings of the study are based on scientific analysis; for instance, presenting findings in ratio or percentage form is undisputable.

This study has limitations in terms of its scientific merit. It used the data collected from a small sample of hospice providers in a single geographic area, and thus cannot be probabilistic. The findings cannot be generalized; the survey should be repeated in a larger geographical area, with a larger representative sample, and in other countries. Secondly, many results of this study may be specific to the United States only; for example, in other countries, it is recommended that pharmacy technologist should fill the pillboxes instead of nurses. Another limitation of this study is the non-response in data collection. Some respondents decided not to answer some questions; this renders some percentages as conservative. This study is one-sided. Despite the fact that the sample is multidisciplinary, the findings reflect only those hospices that were surveyed. Adding the patients and caregivers to the research sample may give more insights into the additional methods that the patients might perceive to be more effective. Finally, the responses might have been influenced by survey conditions and time constraints despite the efforts to minimize distractions and inconsistencies in administering study.

Do the Conclusions Answer the Research Questions in the Definition of the Problem?

The findings of this study support the hypotheses. Firstly, the hospice providers lack knowledge in their experiences and methods in assessing and helping the informal and unpaid caregivers to manage medications. Very few hospice providers consider ensuring proper medication management as an important aspect of home hospice care delivery. Secondly, the findings of this study provide important insights for future intervention that include evidence-based tools and in-service training to support the practice. Importance of medication management varies from one hospice agency to another. Organizational culture may need to be applied in the intervention so as to improve the practice of medication management in different hospice agencies. As seen from practice, institutional protocols and consensus recommendation of facilitating management of medication may need to be updated. It is evident that ensuring proper and safe medication management among caregivers is very important, but challenging for many providers and many caregivers to execute.

Are the Conclusions Appropriate?

The conclusion made by Joyce and Lau is appropriate. In their conclusion, the authors say that supporting caregivers in medication management is important. This is especially because in the past, unpaid and informal caregivers have been left behind regarding the delivery and provision of the safe management of medication to alleviate pain of end-of-life patients. Additionally, informal and unpaid caregivers have significantly failed in relieving the symptoms in some patients. The conclusion is very appropriate, because the authors acknowledge that ensuring that informal and unpaid caregivers deliver quality services will be challenging. The authors conclude their study by offering a solution that can help caregivers effectively provide their services. They mention that additional resources will be needed to help providers effectively and consistently support and assess caregivers medication management.

Do You Have Enough Information to Make a Decision on the Effectiveness of the Study? If So, Is It Effective?

I have sufficient data to make a verdict on the effectiveness of this study. Today, in the United States, there is quite a lot wonderful hospice staff serving the country; some are extremely caring and dedicated. However, in some cases, problems appear because of a simple judgment, carelessness, ignorance, and unintentional actions. At other times, greed may get better of some hospice staff and may prevail over abiding by the standards of care. The staff may choose to cut corners in certain situations; as a result, devastating results affect the patient and his/her family. This study is effective, because it does not portray hospice workers as always bad. I know that even the rogue hospices are not always bad. They manage to provide excellent service to one patient but fail to do so to another patient. This is because often they face different cases in trying to help informal and unpaid caregivers. The healthcare is in a constant flux. It is ever-changing and evolving. While there is a continued pressure to cut services and cost, the standards of care must remain to be decent and of good quality. The study is effective, because it realizes that there is no distinct solution to the challenges facing the hospice care. The study, however, mentions that increasing financial funding to the healthcare will go a long way in ensuring that the best hospice care is offered to the patients.

References

Joyce, B. T., & Lau, D. T. (January 01, 2013). Hospice experiences and approaches to support

and assess family caregivers in managing medications for home hospice patients: A

providers survey. Palliative Medicine, 27, 4, 329-338.

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