Opioid Use in Hospice Care – Care Example

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"Opioid Use in Hospice Care" is a wonderful example of a paper on nursing homes. The major purpose of this research critique part two is to assess a clinical research study that was carried out to study the use of opioids in hospice care. In health care practices, opioids are used in the management of several health conditions. In the United States, opioids are commonly used for the management of chronic obstructive pulmonary disease. As well, health workers especially physicians have varied attitudes towards the use of opioids for the treatment of dyspnea.

This paper tries to explore the use and knowledge of primary health care workers and respiratory therapists in the management of advanced chronic obstructive pulmonary disease (COPD), as well as opioids, use in managing dyspnea. The setting of the research was in a primary health care facility. The researcher identified some of the benefits as well as risks that are involved in participation in this study. The respondents were primary health care workers in addition to respiratory therapists. One of the benefits that the author identified for taking part in this study is the acquisition of more knowledge and experience towards the use of application of opioids in the management of several conditions in hospice care.

Through answering various questions relevant to the use of opioids in hospice care, the primary health care practitioners together with respiratory therapists will gain a lot of knowledge in the process. However, there are a number of risks involved in participating in this study. The author did not mention any risk of participation. Through taking part in this study, the working morale of the health cares workers because there is a possibility of discovering where they lack proper knowledge concerning the application of opioids in the treatment of various conditions.

It can as well lead to the anxiety of knowing other things related to opioids that are not useful in a primary health care setting (Mercadante, Ferrera & Casuccio, 2010). Prior to starting this research, the researchers acquired some information concerning the experience of primary health care workers’ towards the use of opioids to treat different diseases. They distributed consent forms to potential subjects and collected them after they were filled.

Because they had informed consent, they knew which questions to ask. In addition, study subjects were informed of the kind of questions they were going to answer. The research started only after all participants agreed to take part. All relevant information was given to subjects hence there is no participant who did not understand what was supposed to be handled (Mercadante, Ferrera & Casuccio, 2010). All subjects participated willingly without any influence. The research informed management of the primary health facility that the study took place before embarking on data collection.

The institution approved their request and allowed them to use their facility together with its health workers. Local Research Ethics Board according to the requirements also approved the research (Mercadante, Ferrera & Casuccio, 2010). In this study, the authors did not identify independent as well as dependent variables. An example of a dependant variable in this study was the time duration that the worker has been using opioids to manage COPD in primary health care settings. Whether the health worker is a general physician or else a specialized respiratory therapist is another variable.

The authors were supposed to identify the variables in this study (Mercadante, Ferrera & Casuccio, 2010). The researchers did a random sampling of primary health care facilities and selected one health facility. Within the health facility, they recruited family physicians as well as respiratory specialists who have experience in the treatment of COPD using opioids. The two groups were chosen because they have close working relationships in a particular outreach organization that deals with respiratory conditions. The researchers collected data from ten family physicians plus eight respiratory specialists.

The total sample was made up of eighteen subjects. Oral interviews were used to collect data. Before beginning the interviews, participants were given a brief form that required them to fill in information related to their status as well as gender. In this form, they filled their ages, gender, practice setting, and the number of years they have been working. Subsequent data collection involved direct interviews with each clinician. Each session took between 30-45 minutes. They came up with a semi-structured interview guide to discover their medical knowledge, experience, and their opinions concerning managing patients with advanced COPD, and their comfort with managing dyspnea in addition to prescribing opioids for dyspnea.

All interviews were audio-recorded. The researchers did not provide a specific time over which this research was carried out (Mercadante, Ferrera & Casuccio, 2010). Because of the word for word transcription of digitally audio-recorded information, a research assistant that had experience in NVivo 7.0 software, as well as qualitative research, applied an interpretative technique to analyze the data. Interpretative description involves responding to questions that are persuasive, complex, and contextually fixed questions that have relevance to primary health care settings.

According to the author, their first step in analyzing data involved describing the phenomenon of interest; this examined the experience of family physicians and respiratory specialists in the use of opioids to care for patients suffering from COPD and dyspnea. The next step was a description of what the researchers had observed within that health care setting. The analysis of data in this research study depended on the researchers’ diverse information background, previous knowledge about the use of opioids, and psycho-spiritual. The authors described well the entire process of data analysis.

They mentioned all steps that were involved in data collection, data management, and data analysis. They mentioned methods that they applied to make sure that data collection and analysis was reliable. They also identified the decisions they took during data management and analysis. To ensure that collected data is correctly analyzed, the researchers applied data analysis software that ensured the correct analysis of information. To ensure that the effects of researcher bias are minimized, the researchers together with a research assistant analyzed the data separately.

After analyzing data separately, they compared their results. The author specifies that their separate analysis had slight differences that could not affect the main results. They as well selected the primary health care facility after a random sampling that minimized bias in the selection process (Burns & Groove, 2011). The researchers found out that all study subjects had a minimum experience of seven years using opioids to manage a number of conditions. To avoid confusion in this study, researchers narrowed down to two conditions only: COPD and dyspnea.

All respondents had worked in both rural and urban settings within the same field. The collection and interpretation of data based on this facility were correct. However, according to me, the findings of this research are not a true reflection of reality. The data was collected in a single health facility and all respondents came from the same facility (Mercadante, Ferrera & Casuccio, 2010). This cannot represent the experience that all primary health care practitioners have in the use of opioids for the management of several diseases in hospitals.

A limitation of this study was that the information given by subjects about their experience might be wrong (Burns & Groove, 2011). The study has an implication on nursing practice because it can be used to show the experience that nurses working in various settings have concerning the use of opioids. It can help to realize a need for equipping nurses with more information about the use of opioids in hospice care, especially nurses that deal with conditions like COPD and dyspnea. Further studies should involve many clinicians from different facilities.

Studies in this field are useful for nursing practitioners because they mostly encounter situations that might require the application of opioids to manage a certain condition (Burns & Groove, 2011).

References

Burns, N., & Grove, S. (2011). Understanding Nursing Research (5th Ed.). Elsevier. ISBN-13: 9781437707502.

Mercadante, S. Ferrera, P. & Casuccio, A. (2010).The use of opioids in the last week of life in an Acute Palliative care Unit. American Article of Hospice and Palliative Medicine, 514-517.

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