NUR 318 Module 1 Qualitative Research Critique Example

Listening, Informing and Watching: A Critique of a Narrative Study of How Surgical Nurses Relieve Postoperative Nausea

Student Name

Edson College of Nursing and Health Innovation, Arizona State University

NUR 318: Nursing Research and Evidence Translation

Instructor Name

Month Day, Year

Listening, Informing and Watching: A Critique of a Narrative Study of How Surgical Nurses Relieve Postoperative Nausea

Postoperative nausea and vomiting is one of the most common complaints after anesthesia, and it is also one of the complaints patients remember longest. Most of the research on it measures drugs: which antiemetic, at what dose, given before or after induction. Far less of it asks what nurses actually do at the bedside when a patient turns pale and reaches for the emesis basin. That gap is the starting point of the study critiqued here, a narrative inquiry by Börjeson et al. (2010) published in the Journal of Clinical Nursing. The critique follows the qualitative appraisal questions in Polit and Beck (2022) and closes by asking whether these Swedish ward findings would hold in an American day surgery unit.

Problem, Purpose and Significance

The authors state the problem clearly. Postoperative nausea and vomiting is described as frequent and distressing, yet the nursing role in relieving it has been studied very little. The purpose follows in one sentence: to illuminate the experience of nurses in relieving postoperative nausea and vomiting. That wording suits a qualitative design, because it asks about experience and meaning rather than effect size or frequency. A reader can see why the question matters to nursing in particular. Antiemetic orders come from anesthesia providers, but the patient spends the recovery hours with nurses, and whatever comfort measures are used between doses are nursing decisions.

The significance argument could be stronger. The introduction says little about how often nausea delays discharge or leads to unplanned admission, figures that would show a hospital administrator why nurses' practices deserve study. Even so, the problem is focused, the purpose is matched to the design, and the reader is told what the study does not attempt, which is to test any intervention.

Design, Setting and Sample

The design is described as a qualitative approach using narratives, analyzed with a hermeneutic narrative method drawn from Polkinghorne. Narrative inquiry treats the stories participants tell as the data, on the assumption that people make sense of their work by telling it as a sequence of events with a point. For a question about how nurses experience a recurring clinical problem, this is a reasonable choice. A phenomenological design could also have fit, but the narrative approach has the advantage of keeping each nurse's account whole, so the reader sees actions in context rather than as isolated codes.

The sample was ten female nurses from two general surgical departments at a Swedish university hospital. Polit and Beck (2022) note that qualitative samples are judged by whether they are information rich, not by their size, and ten experienced nurses describing a problem they meet weekly can supply rich data. The limits are still worth naming. All participants were women from one hospital system, and the paper gives little detail about years of experience or how participants were invited. A reader cannot tell whether the nurses who volunteered were those most interested in nausea care, which would tilt the stories toward skilled practice.

Data Collection and Analysis

Data came from interviews that were recorded and transcribed. The interviews invited nurses to tell about situations in which they had cared for a patient with nausea or vomiting after surgery. Open prompts of this kind fit narrative inquiry because they let the participant choose which events matter. The report would have been easier to judge if it had included the opening question word for word and the length of the interviews, both of which help a reader decide whether saturation was plausible.

The analysis is described as hermeneutic narrative analysis, meaning the researchers moved back and forth between the parts of each story and the whole until a coherent interpretation emerged. The result was organized as a set of nursing tools. Polit and Beck (2022) advise readers to look for an audit trail that shows how raw text became themes. The article gives the method's name and its steps in general terms but offers few examples of how a passage of interview text was turned into a category, so the path from data to findings must partly be taken on trust.

Trustworthiness and Ethics

Qualitative rigor is judged through credibility, dependability, confirmability and transferability rather than validity and reliability. Credibility is supported by the use of several researchers in the analysis and by quotations that let nurses speak in their own words. Dependability is harder to judge because the report gives limited detail on how disagreements between analysts were settled. There is no mention of member checking, in which participants review the interpretation, so a reader cannot know whether the nurses would recognize themselves in the four tools. Transferability depends on description of the setting, and the paper describes the wards only briefly.

On ethics, the authors report approval from a regional ethics board and informed consent from participants. Because the participants were nurses describing their own work, the main risk was disclosure of practice that colleagues or managers might judge. The report's assurance of confidentiality addresses that risk adequately.

Findings

The nurses described four kinds of tools: listen and understand, information, the clinical eye, and availability. Listening meant taking the patient's account of nausea seriously and finding out what had helped before. Information meant telling patients what to expect and what they could do themselves, such as breathing slowly or asking early for help. The clinical eye was the nurse's practiced reading of color, posture and restlessness, often before the patient said anything. Availability meant being present, or at least reachable, during the hours when nausea peaks. The authors add that some nurses had more skill with these tools or more opportunity to use them than others, which links the findings to staffing and workload as much as to individual skill.

The findings are presented with enough quotation to be believable, and the four categories are distinct rather than overlapping. Their main contribution is the idea that relief depends on giving patients a sense of control over their own situation. That conclusion is consistent with the data shown, although a reader might ask how much of it comes from the nurses and how much from the analysts' interpretation.

Usefulness for Practice

Qualitative findings are not meant to prove an effect, but they can shape what nurses look for and what they try. In an ambulatory surgery center, the recovery period is short and patients go home within hours, so availability and information take on extra weight. A nurse who asks a patient in preoperative holding about past nausea is using the first tool before it is needed. A nurse who teaches slow, controlled breathing and leaves a call light within reach is using the second and fourth. These are low-cost habits that sit comfortably beside antiemetic orders and do not replace them.

The study also raises a question that later modules of this course could pursue: whether simple nonpharmacologic measures that give patients something to do, such as controlled breathing or inhaled aromatherapy, reduce nausea or rescue medication use. Trials of inhaled agents exist, and some suggest the act of controlled breathing may itself explain part of the effect (Anderson & Gross, 2004). The critique therefore ends where the course's evidence project begins.

Conclusion

Börjeson et al. (2010) offer a clear, well-matched qualitative study of a problem that nursing research has largely left to pharmacology. Its strengths are a focused purpose, a fitting narrative design and distinct findings presented with participants' words. Its weaknesses are thin reporting of recruitment, interview questions and analytic decisions, and the absence of member checking. Read with those limits in mind, the four tools give an RN in a surgical or day surgery unit a practical vocabulary for nausea care and a reason to treat patient control as part of the treatment.

References

Anderson, L. A., & Gross, J. B. (2004). Aromatherapy with peppermint, isopropyl alcohol, or placebo is equally effective in relieving postoperative nausea. Journal of PeriAnesthesia Nursing, 19(1), 29-35. https://doi.org/10.1016/j.jopan.2003.11.001

Börjeson, S., Arweström, C., Baker, A., & Berterö, C. (2010). Nurses' experiences in the relief of postoperative nausea and vomiting. Journal of Clinical Nursing, 19(13-14), 1865-1872. https://doi.org/10.1111/j.1365-2702.2009.03176.x

Polit, D. F., & Beck, C. T. (2022). Essentials of nursing research: Appraising evidence for nursing practice (10th ed.). Wolters Kluwer.