Critical Appraisal of an Article

Abstract

This paper provide a critical appraisal of an article that was aimed at examining a diary of a patient that indicated how she coped with facedown position after she underwent a macular analysis. The study article to be analysed examined the narrative of a self-motivated person about the obstacles she faced during her postsurgical requirement. The summary of the diary content was done qualitative analysis method, that is, thematic analysis. The article came up with seven areas of study including the emotional state of the patient, sleep quality, visual functioning, social support, physical status and her entertainment needs.

Introduction

This paper discusses the thematic analysis method used in analysing the areas of the study that emerged from examining the diary. The paper also describes how trustworthiness was addressed in the in the study considering that any study is aimed at being used widely in other areas of study or application.

 

System for grading Strength of Qualitative Evidence in this study. table 1

Good evidence			Fair evidence		Insufficient evidence
			There was one study selected where the methodology used was qualitative description that used thematic analysis for the reason for analysing data. This method was used to represent the events and experiences as described in the diary by the writer. The application of the methodology was well done so as to come up with a coding schema after each theme was given a meaningful name.
Rigor/quality			Rigor/quality		Rigor/quality
·         The quality of data analysis is high where two investigators were read line by line together through tout the text and scrutinized the diary content and adjusted the scheme of coding accordingly. ·         The sampling method of deviant case was adequate that was purposeful for this kind of study where data being analysed was from a secondary source.			·         The description of the data is consistent with the information contained in the diary since it interprets the daily experiences of the patient without deviating from them. ·         The study used three levels of abstraction for data analysis that include textual description, use of a table and a model that was used to describe the information contained in the diary.		The study does not identify any bias in the expression of the experience by the author of the diary or its existence in the analysis of the recorded information.
Credibility/consistency			Credibility/consistency		Credibility/consistency
·         Authenticity-the data used was got from the patients diary and did it could be confirmed by the patients relative who were part of the experience the author underwent ·         Conformability- the data does not represent the views of the researcher and the coding done by someone outside the field. ·         Credibility- the data is the same as represented in the diary and the interpretation matches with the diary content. ·         Criticality-it is free of personal bias since it’s not the researchers’ opinions but the contents of the author. ·         Transferability; the findings of the study can be compared to the experience of different patients who underwent a similar surgical procedure.			·
Relevance/feasibility			Relevance/feasibility		Relevance/feasibility
There were no concrete reasons for the results of the study not to be applied by the patients and the medics.
A coding schema for the content of the diary including examples. Table 2
Category	code	Information regarding		Quote
Emotion	Time                 Hope     Feelings	Time in the context of the things she had to do after the surgery to enable healing             Feelings about the success of the whole recovery process.   The interpretation of emotions and feelings		Having everything fitted in ten minutes an hour was impossible and I developed the habit of allowing myself twenty minutes during the morning to ensure I did posturing for one hour, forty minutes before and after.     I saw a big black floater that worried me, I rang the Eye Infirmly who thought that is normal. my vision has improved much, to my relief, better than it was before the surgery.
Vision	Bubble     Function       Health	The gas bubble in her eye     What she can see or cannot see     Visit to the doctor and eye drops		The gas bubble could be seen clearly     The distortion in my central vision was still slight, but could watch TV and read books normally.   While leaving the infirmary, I was given eye drops bottles , I ran out of one bottle and I after finding out the drags were out of the  counter in a pharmacy I made an emergency visit to the doctor at the eye affirmatory.
Body	General	Health other than visual         Personal care		Because of a lot of hand washing to prevent infection my skin became very dry and cracked and I had to apply hand-cream between washes   I was not allowed to shower as water getting into the eye was to be prevented.
Others	Support received	Support given by others on personal care     Social support		I was forced to rely on a friend to come over early in the morning to run for me a bath and to change the beddings. A

 

 

 

 

Thematic analysis as qualitative descriptive tradition

This research article has widely used thematic analysis for the purpose of analysing data contained in the diary. Thematic analysis is a system used to recognize and analyse patterns that can be found in qualitative data. It is an analytical method but not a methodology. The purpose of the method is to principally recognise the patterns of meaning in a dataset so as to provide a qualified answer to the research question that is being addressed in a study (Clarke, Braun, 2013).. In this particular case the, the author has used thematic analysis to look into how the patients for macular hole surgery cope with the face down position in the recovery process.

Thematic analysis is one of the many qualitative descriptive tradition that aim at developing concepts that can be applied in trying to understand the social phenomena  and putting emphasis on the meanings of the experiences and views of the participants in a natural setting. Thus the thematic analysis is used by the authors of this article to analyse the experience of the diary’s author while undergoing the face down procedure as a requirement for the healing process. This analytical method is advantageous in that it is flexible theoretically, meaning that it is possible to use it with different frameworks to help answer different kinds of research question (Mohammed, 2012). It is suitable to people’s personal experiences, their views and perception arising from such experiences. Thus it suits questions that requires one to understand the data and then give a representation of the data according to their understanding. This method is suited to a broad range of research and theoretical perspectives thus it is good when used as a basic method. There are different ways of approaching thematic analysis. The first is the inductive way where the coding and development of a theme are directed by the data content. The other one is the deductive way where coding and development of a theme show the explicit data content and a latent way whereby theme development and coding theories and assumptions involving the data. The other one is the essentialist whose focus is on report on assumed reality that is evident in a data set. Last one is the constructionist way whose focus is on checking how data creates a certain reality (Mohammed, 2012).

The thematic analysis used by the authors in this article has used six phases. The first phase involved looking for the theme in the data, where the information in the diary was examined to identify available pattern of meaning. There was summarising each section in order to reveal the major theme. The second phase involved reviewing the themes where each theme was checked against the information recorded in the diary and then given a meaningful name. This approach then resulted to the initial coding schema. The fifth face involved familiarising with the information obtained from the diary. In this phase there was reading of the data so as to be thoroughly familiar with information contained therein. This involved two investigators reading the text line by line in the entire text checking the content keenly so as to adjust the coding schema accordingly (Wittich, Southall, 2008).  The process of coding is very essential for the purpose of systematic and thorough engagement so as to come up with a rich and complex analysis that will be able reach beyond the meanings that are obvious in the data. Failure to develop codes that will evoke the data successfully may lead to problems themes will be determined by the codes themselves.

 An important aspect in thematic analysis is evaluation of themes and codes in to ensure their reliability in representing the entire text. The researcher should use the help of an outside reviewer during the early stages of the analysis of data who will evaluate and identify the themes in the data under study. This is important to ensure that those themes and codes are reliable and consistent with the whole of the text or not. The researcher can then compare the report against the feedback from the independent reviewer and this whole procedure will go a long way in ensuring that reliability is built in themes analysis and coding. The researcher will be better informed about any conflicting results if they exist in regard to the themes that may have been removed by the independent reviewers (Mohammed, 2012). The authors of the article being analysed have applied this procedure more so in the coding process. Once the codes and application planned for them were deemed satisfactory, the researchers recruited a colleague from outside their field so as to code a section of the diary that had been randomly selected. The independent reviewer was given the codes, their definitions and the procedure they should follow while in the process of coding. The level of reliability was indicated when acceptable accuracy was arrived at the first trial and thus the researcher were satisfied with the list of codes.

Thematic analysis can also involve a model. Such a model has various functions namely reduction of the data, displaying of data and the conclusion of such data.  Reduction of data refers to the process where data is chosen, focused, simplified, built and transformed. The researcher can apply new thoughts and ideas in regard to what should be included in the data displayed in the model. This stage focuses on information visualisation by applying various techniques of display like quotations, figures, narrative text, tabulating similarities and differences and making clear the relationships that include complexity of data associated with the study. The advantage of using various data display techniques in thematic analysis makes clear the description of the comparison and the similarities (Mohammed, 2012). The researchers in the article uses tables and a model diagram in order to make the content of the diary more clear and simple. The model has a simplified structure that builds a visual summary that shows a representation of the most noticeable content information in the diary. The representation helps the viewer to visualize and understand the psychological and emotional part of the experience of the rehabilitation programme that the diary’s author underwent (Wittich, Southall, 2008).

The final stage in thematic analysis is involves the drawing and conclusion of the data. The method can adopt various ideas to come up with the meaning of the data obtained from various sources. Such may include noting various patterns and themes, whether any statement is relevant especially in the case of similarity or contradiction. The researcher may also put into groups or come up with categories of information that can be deemed similar or can go together and the researcher can identify how factors and variables interrelate. Moreover the researcher can also result to building conceptual consistency and rationality and, at the end the analysis method can be used to discover the legitimacy of the findings in order for them to be applied in the theoretical framework of the research (Mohammed, 2012).

 

Trustworthiness of the study.

This is clearly expressed in the study from the early stages of the analysing the data where two investigators were given the chance to read through the text, line by line, checking keenly through the content of the diary together , while at the same time including adjustments in the coding scheme where necessary. Also, after the lists of the codes and their planned implementation were deemed satisfactory, the researchers embarked on test interrater reliability which was considered to be necessary. To do this, the researcher recruited a reviewer who had no association with vision   rehabilitation. The reviewer was tasked with coding of section of the diary that had been selected randomly. The individual was given the lists of codes as well as the definition of the codes, together with a procedure that he had to follow in the process of coding.  This lead to an establishment of reliability of the codes used after calculation of the number of passages that had been coded similarly which were then divided by the number of coded passages.  Moreover the researchers also sort the assistance of an external professional who has specialised in the vision rehabilitation field in order to review the information from form a clinical point of view and the professional confirmed that the themes found in the analysis are commonly encountered (Wittich, Southall,2008).

Conclusion

The rating of the article can be termed fair in representation of evidence to support the study. The paper has shown a high level of reliability because it involved the views of external professionals and viewers and thus can be referred by other studies on similar field.

 

 

Reference

 Wittich, W., Southall K,(2008).Coping with Extended Facedown Positioning after Macular Hole surgery A Qualitative Diary Analysis.

Mohammed, A. (2012) .Thematic analysis: a critical review of its process and evaluation WEI International European Academic Conference Proceedings. 12

 Clarke, V. Braun, V. (2013). Methods. Teaching thematic analysis. The British Psychological Society. Retrieved from