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Healthcare Essay Critiquing Research Process in Health Care Practices

Question

Task: Overview: This is an individual healthcare essay in which you will critique the research process in the context of health care practice. It is important to be fully aware of how research is structured and interpreted to apply to your own academic reading and research projects.

1. Analysis:

  • Identify 8 major steps/components of the research process.
  • Analyse the purpose of each step of the research process with at least one example to support your analysis.
  • Explain the significance of “Literature Review” as a major component of research process.

2. Critique:
A. Ethical aspects in the research process are often controversial and unethical behaviour is taken very seriously by all stakeholders.

  • Critique 4 ethical aspects of healthcare research. Support each ethical aspect with the help of a significant example/case study. Try to select examples/case studies from healthcare research in Aotearoa/ New Zealand.

B. Legal aspects differ from ethical issues and taken equally seriously.

  • What are the legal implications of plagiarism, falsification and fabrication in the research process?
  • How can legal issues be avoided?
  • Support your answers with examples from reliable academic sources.

3. ‘Critical examination’ of research methods and methodologies in the context of healthcare practice.

Research methodology(ies) include qualitative, quantitative, and mixed methodologies.

  • Which methodology(ies) would be most appropriate to healthcare practice research and why? Research method is the way in which data are collected.
  • Which research methods are most effective in healthcare practice and why?

4. Application of research methods and methodologies

  • How and why are specific research methods and methodologies applied to evidence-based healthcare practice in a New Zealand context?

Answer

Introduction
The concept of research explored in this healthcare essayis characterized as a deliberate examination, including research advancement, testing and assessment, intended to create or add to generalizable information. This is a wide definition that may incorporate biomedical exploration, epidemiological examinations, and wellbeing research, just as investigations of behavioural, social, and monetary variables that influence wellbeing. The most natural type of wellbeing research is the clinical trials, wherein patients volunteer to take part in investigations to test the viability and security of new clinical mediations (Huskins et al., 2018, pp. 1140-1146). Be that as it may, an undeniably huge bit of wellbeing research is presently data based. A lot of exploration involves the investigation of information and natural examples that were at first gathered for symptomatic, treatment, or billing purposes, or that were gathered as a feature of other examination projects, and are presently being utilized for new exploration purposes (McCormack et al., 2017).This essay shall highlight the research methods in healthcare practices where process of healthcare based research will be analysed. The ethical mannerisms shall be critiqued, legal aspects of conducting a healthcare research and repercussions of data falsification in it will be discussed along with various methodologies used and which ones are effective. Thereafter in context of New Zealand’s healthcare practice, application of certain methodologies applied will be discussed further.?

Discussion of research practices and processes
Analysing Research process

A good research process has 8 stages. A diagram has been provided below to understand the flow.

source created by author in healthcare essay

(Source – created by author)

The first step of selection of a research problem or an area that interests one is very important. This lays the foundation of the entire research. It is expected to select a research problem that professionally or personally self-interests the researcher. It gives ingenuity to the project and sets the path to proceed (Dive, n.d). Without a problem, the project will be solutionless as well.

The next stage of forming a hypothesis or formulation of aims, objectives and research questions.Whether the research can proceed with proving hypothesis or it needs research questions very much depends on personal approach taken for the research. With a well defined problem, appropriate objectives ca be set and right questions can be asked that the research will seek to answer. Just like, without asking the right question, we often do not find the desired results on a search engine page (Ioannidis, 2018, p. e2005468). The crisper the question, precise is the answer. While some may not denote it as a part of research process, literature review starts even when a research problem is being investigated. This is simply because one needs to check if the problem has been investigated before. Also, after forming the hypothesis or the aims and objectives, a lot of reading needs to be conducted as part of secondary data research which could include journals, articles, web based articles, magazines, news publications and so on. So, literature review is a crucial step in conducting a research (Theofanidis&Fountouki, 2018, pp. 55-163) .

The significance of literature review also lies in the fact that the rationale to conduct the research that one has opted for needs to be clarified. By reading the studies that have already been conducting in the field and pointing out through critique what was overlooked or was missing, one can explain the additional need for research that they will be conducting("What is a literature review?", 2021). It thus, helps to identify the purpose of conducting further research. For any research, the literature review is an important and mandatory portion as it achieves certain significant goals for the researcher and people who will be going through the research. It broadens the research setting, unmistakably differentiates what is and what isnot inside the extent of the examination, and justifies the choice of research. The literature review is responsible for widening the research landscape which have been reviewed by the researcher thus providing it awidespread academic and certifiablebackground. Also, it inspects the exploration strategies used for previous studies and helps realize whether the events are acceptable. Such a valuation of the researchendows the student to acknowledge what has been realized and achieved in the space of study and what actually should be realized besides achievements (Snyder, 2019, pp. 333-339). Additionally, this sort of review permits the researcher to not only exclusively sum up the current studiesbut also, incorporate it sin a manner that a new perspective shines. In this significant way, a decent literature review is the premise of both hypothetical and methodological refinement, consequently improving the quality and helpfulness of ensuing exploration.

The next step of selecting a data capture method, happens after contemplating the pros and cons of all the available methods In this step, research instrument is also selected which means, the means of collecting the data, whether it will be a survey, creating interview questionnaires and so on("Data Collection", 2021). This is also the stage where field testing of the research tool is also necessary along with selection of sample to conduct the research. This is like research but done on a small scale in a limited group. Benefits of doing in a small scale are this that the hypothesis can be checked easily and faster. Selection of a good sample is important as based on the accuracy achieved in sample the larger estimates’ accuracy can be rested. The sample study and results derives are considered as a true reflection of the actual study conducted(Taylor et al., 2017, pp.86-98). After this, comes the stage of data analysis. In this stage, the accumulated data is presented in a comprehensive and legible format such that one can notice and draw conclusion based on patterns arising. Methods such as qualitative or quantitative selected allows researcher to best present the data gathered. This can be like clinical trials conducted in healthcare research for a new drug whose end results are then presented to public in a manner that is best easy for them to interpret and take a decision.

After all this, time has come to draw some conclusions. This stage helps readers to reconnect the aims, objectives and research questions that were initially set out for study by researcher to connect to the data presented and see if the study gave a favourable answer or not. If not, this is where limitations the researcher faced while conducting the research also needs to be revealed and future research suggestions as well (Agger et al., 2017, pp. 3-9).

The last stage is reporting the results or completing the research. This is where the researcher actually writes the research in a document. The research underwent all the stages discussed, they need to be properly segregated into different chapters and present it in a legible way as draft. This stage helps sum up what was done, how it was done and what were the findings.

Critique of ethical aspects
Ethics represents the sense of solidarity with other human beings. The four principles of ethics are – non maleficence (Primum Non Nocere) or do no harm, beneficence-caring for others or do good to others, autonomy – respecting self will to conduct one’s life and justice – being fair to everyone. As of late, there has been extensive discussion about the moral conduct and reviewing of healthcare based research, yet this discussion has to a great extent occurred among ethicists and specialists in industrialized nations only. The perspectives on general healthcare professionals and scientists from developing or underdeveloped nations have been underrepresented.

One of the ethical aspect of healthcare research is informed consent. Now, if the case of ethical governance framework updation work in New Zealand is taken for health data research, the blatant diabolism can be viewed (Marsh et al., 2017). For this task itself, both the amount of information and need for admittance to utilize this information for research are developing. Better usage of research data is definitely part of New Zealand government’s social investment approach’. This is because it plans to utilize the large repository of data to advance public systems, save costs and can focus the research for even better results. It tries to do this by applying thorough, proof based investment practices upheld by technology. In the healthcare setting, secondary use research includes the utilization of clinical information for tasks other thanthose for which the research was conducted in the first place and the patient had given consent. So, while this is necessary step; it violates the ethics principle. The ‘Unfortunate Experiment’ case is one such example of misuse of informed consent, in this case that of unconsented gynecological examination at National Women’s hospital (Coney, 2020, p. 232).

Another, ethical aspect, that of justice or being fair to everyone means that everyone is equally treated as a human and all rights are equally distributed. However, breach in this happens when it comes to inclusion of women in clinical trials. Pregnant ladies are often not included because of so called ‘additional risk’ (Van der Zande et al., 2017, pp.657-663) . Unfortunately, women are not even asked of their will in this case to be a part of the clinical trial. How is this ethical then? Should the welfare of pregnant ladies not be part of the benefits from the research? The very guidelines of clinical trials and the questionnaires are made so that the answer leads to a non by the pregnant women. Example is the absence of pregnant women in any clinical trial based study that is directly not studying just pregnant women.

Professional accountability is of highest need among doctors as they are the ones who will be also part of healthcare research however, the New Zealand law protects the doctors to the extent that under the Health Practitioners Competence Assurance Act, the disciplinary process safeguards public figures (Heke et al., 2019, pp. 606-612). Even in cases of medical negligence which may have led to manslaughter, the Coroner and Court holds only minor responsibility. Post a law revision in 1997, that of Crimes Act where threshold of medical manslaughter was lifted from ordinary to gross negligence and cases dropped drastically. There was a case after 3 yrs in 2000, that too of an alleged manslaughter when a midwife did a breeched delivery leading to death of baby, she was found not guilty in 2006 (Peden, 2018).

Another ethical breach is that of ensuring everyone has access to customized medicine. This field usually uses genome based data and treatment is also mostly so costly that not everyone has access to it. This raises questions on equality of rights, inequality of income and equal access to medicine. Here, a research conducted by two scientists specifically highlights New Zealand’s Maori population who have almost no access to healthcare (Hikaka et al., 2021, pp. 1-13). This disparity could be based on various components, including race, income and so on.

Legal implications of falsification, plagiarism and fabrication of data
The field of scientific exploration draws in tremendously skilled people in both scholarly community and clinical practice. Public and private organizations routinely support and advance their exploration attempts, and government contributes a huge number of dollars every year on these pursuits. However, the pressing factors of scholarly and clinical examination settings are high, and analysts and research colleagues might be enticed to compromise, putting research integrity to danger (Sankar & Parker, 2017, pp. 743-750). To secure their foundations, chiefs should set up prescribed procedures for identifying and reacting to charges of research misconduct — and guarantee these cycles are followed.

Research Misconduct is characterized by government law and University policies as creation, misrepresentation, or copyright infringement in proposing, performing, or surveying research, or in announcing research results. Fabrication is making up information or results and recording or revealing them. Falsification is manipulation of research materials, gear, or measures, or changing or discarding information or results to such an extent that the exploration is not precisely addressed in the exploration records. Plagiarism is the apportionment of someone else's thoughts, cycles, results, or words without giving proper credit.

Inappropriate practices that are not characterized as research misconduct might be viewed as offense under other University arrangements including, yet not restricted to, irreconcilable situation, licensed innovation, biosafety, utilization of human and animal subjects, monetary administration, utilization of University offices, outside proficient exercises, representative relations and faculty-student relations (Rennie&Gunsalus, 2019, pp. 29-51).

Questions identified with research that don't include research misconduct behavior or other offense ought to be settled inside the proper research groups, center, or office. Such questions may identify with origin, attribution of credit, privacy, admittance to or understandings of information, straightforward carelessness, contrasts of assessment, or legit mistake.

While there are many repercussions, in terms of legal aspects, the researcher may lose his job, may be taken criminal action against owing to being a fraud, loses credibility in circle, may be fined or incarcerated. Hence researchers may face civil or criminal penalties. Legal issues cannot be avoided in case a research misconduct has taken place. Steps can be taken to avoid misconduct. Steps such as staying transparent when it comes to conducting the research, keep an amicable relationship with peer and discuss the findings, not avoiding questions and carefully addressing all doubts is vital. It's the kind of situation that can malign an organization's standing in a moment when news leaks that a star performer in research, conducted fraud, when there were millions of funding involved. Now, the institution will face legal actions and will have to pay in compensation, millions of dollars.

There needs to be in place appropriate policies related to academic research and healthcare research which are actually followed and not just on papers. There needs to be a standardization for supervision at all stages of research tests. Process rigor is mandated so that progress can be crosscheck historically. Appropriate accounting of time dedicated to research work is done. Appropriate expectations are also set for what can and cannot count. Not only this, the institution must also reevaluate the grant accounting function such that they do not fall in legal trouble in case of a mishap (Tourish& Craig, 2020, pp. 174-187).

Critical Examination of research methods and methodologies in healthcare practices
The two major research paradigms are positivistic or quantitative and naturalistic or qualitative. They represent two different perspectives of conducting a research. For qualitative perspective, knowledge comes from internal reality and for quantitative research, knowledge comes from external and measurable reality. Qualitative perspectives are more fluidic compared to quantitative perspectives which are fixed or unchanging. Many researchers believe in both and conduct a mixed method research which combines both the research philosophies (Sileyew, 2019).

Healthcare research actually involves interaction with a lot of people or what is known as patient engagement. Point to be noted here is this that not many researchers can have that access, mostly because of lack of experience. Incase patient engagement is done improperly or poorly, potential risks cannot be evaded even despite best of intentions and efforts.

This is why qualitative healthcare research has taken precedence and is popular in healthcare research. A good qualitative research could incorporate patient’s experiences and narration into the design of the research, can access many diverse perspectives of patients, treat them equally and as partners on the research team (Majid & Vanstone, 2018, pp. 2115 – 2131).

Secondary research method is most effective research method for continuing a research further. There is presence of so much research and ongoing research as well that there is ample data available. Researchers can take permission and also gain access to data of ongoing research or research whose data is not public and use the existing data in research for healthcare practices.

Application of certain research method and methodology in evidence-based-practices in healthcare in New-Zealand
Evidence based-practice or EBP is the honest, clear and reasonable utilization of current best proof in settling on choices about the consideration of the individual patient("UC Library Guides: Evidence-Based Practice in Health: Introduction", 2021). It implies coordinating individual clinical aptitude with the best accessible outside clinical proof from deliberate exploration. EBP has grown over the long run to now incorporate the best research proof, clinical skills, the patient's individual qualities and conditions, and the attributes of the training wherein the wellbeing proficient works (Lehane et al., 2019, pp. 103-108). This points to the fact that mostly secondary research method is utilized as it allows utilization of numerous done and available research data and facts. While the researches accessed could have different types of research methodology adopted, hence it cannot be specifically pointed out that only qualitative methodology is used. It could well be a mixed methodology with ample inputs forming a data in form of pattern, backed by qualitative data as evidence. A good researcher will access just the right studies and quickly analyse the data, may be with the use of Big Data, or other data handling tools to derive the correct statistics to form the base of EBP for pursuing a course.

Evidence Based Practice brings along the benefit of consistent better results which further leads eventually in reduction in costs related to equipments needed for healthcare (2021). Hence, allowing the healthcare organisations to save costs. For instance, old research based practices which involved larger equipments, numerous tools and procedures are now no longer needed because of findings from new research (Robb et al., 2017).

In this way, EBP isnot just about applying the best exploration proof to decision making, but also about utilizing the experience, abilities and training that one may have as a healthcare expert and considering the patient's circumstance and qualities (for example social help, monetary circumstance), just as the practicecontext (for example restricted financing) in which one may be working (Murphy, 2020). This process is clinical reasoning and it utilizes the information generated using mixed-method study and secondary research method to best use. ?

Conclusion
This essay is about various research related information in healthcare practice. Healthcare practice is a forever evolving sector with new research being published almost every day. The first segment of the essay focuses on the research process itself. It discusses the involved eight stages and explains them. The second segment may involve presenting critique post analysing the legal aspect and the ethical aspect of research process. In this section different examples were also quoted in context of healthcare research in New Zealand. The last two sections focused on understanding the method and methodologies involved in healthcare practices, their philosophies, what gets more preference in healthcare research and why. Their application in evidence based practice was also discussed.

References
Agger, P., Stephenson, R. S., & Hasenkam, J. M. (2017). The First Steps into Research. In A Practical Guide to Biomedical Research (pp. 3-9). Springer, Cham.

Data Collection. Ori.hhs.gov. (2021). Retrieved 10 June 2021, from https://ori.hhs.gov/education/products/n_illinois_u/datamanagement/dctopic.html.

Dive, G. Stages in Scientific Research Process.

Heke, D., Wilson, D., & Came, H. (2019). Shades of competence? A critical analysis of the cultural competencies of the regulated-health workforce in Aotearoa New Zealand. International Journal for Quality in Health Care, 31(8), 606-612.

Health.govt.nz. (2021). Retrieved 10 June 2021, from https://www.health.govt.nz/system/files/documents/publications/nz-health-research-strategy-jun17.pdf.

Hikaka, J., Jones, R., Hughes, C., Connolly, M. J., & Martini, N. (2021). Ethnic Variations in the Quality Use of Medicines in Older Adults: M?ori and Non-M?ori in Aotearoa New Zealand. Drugs & Aging, 1-13.

Huskins, W. C., Fowler Jr, V. G., & Evans, S. (2018). Adaptive designs for clinical trials: application to healthcare epidemiology research. Clinical Infectious Diseases, 66(7), 1140-1146.

Ioannidis, J. P. (2018). Meta-research: Why research on research matters. PLoS biology, 16(3), e2005468.

Lehane, E., Leahy-Warren, P., O’Riordan, C., Savage, E., Drennan, J., O’Tuathaigh, C., ... & Hegarty, J. (2019). Evidence-based practice education for healthcare professions: an expert view. BMJ evidence-based medicine, 24(3), 103-108.

Majid, U., & Vanstone, M. (2018). Appraising qualitative research for evidence syntheses: a compendium of quality appraisal tools. Qualitative health research, 28(13), 2115-2131.

Marsh, K., Goetghebeur, M., Thokala, P., & Baltussen, R. (Eds.). (2017). Multi-criteria decision analysis to support healthcare decisions. Cham: Springer International Publishing.

McCormack, B., van Dulmen, S., Eide, H., Skovdahl, K., & Eide, T. (Eds.). (2017). Person-centred healthcare research. John Wiley & Sons.

Murphy, K. (2020). Promoting a culture for learning evidence-based practice: Evaluation of a collaboratively developed framework. In Australian and New Zealand Association for Health Professional Educators 2020: ANZAHPE 2020.

Peden, A. (2018). The Defence of Necessity in New Zealand: The Case for Reform.

Rennie, D., & Gunsalus, C. K. (2019). What is research misconduct?. In Fraud and misconduct in biomedical research (pp. 29-51). CRC Press.

Robb, G., Stolarek, I., Wells, L., & Bohm, G. (2017). The state of quality improvement and patient safety teaching in health professional education in New Zealand.

Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of Business Research, 104, 333-339.

Sileyew, K. J. (2019). Research design and methodology. In Cyberspace. IntechOpen.

Taylor, R. R., Kielhofner, G., Tsang, H. W., & Arbesman, M. (2017). Steps in the research process and characteristics of sound research. Kielhofner’s research in occupational therapy: Methods of inquiry for enhancing practice, 86-98.

UC Library Guides: Evidence-Based Practice in Health: Introduction. Canberra.libguides.com. (2021). Retrieved 10 June 2021, from https://canberra.libguides.com/evidence.

Van der Zande, I. S., van der Graaf, R., Oudijk, M. A., & Van Delden, J. J. (2017). Vulnerability of pregnant women in clinical research. Journal of Medical Ethics, 43(10), 657-663.

What is a literature review?. The Royal Literary Fund. (2021). Retrieved 10 June 2021, from https://www.rlf.org.uk/resources/what-is-a-literature-review/.

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