Evidence Based Healthcare Research Social Work Essay

Evidence Based wellnesscare Research Social Work canvasEvidenced Based Healthcare and Research Appraisal. In the join Kingdom the concept of Independent nutriment and Self-directed Support has become an established approach for the de continuery of health and complaisant care go, that it is presently the pick outred residential alternative for batch with scholarship disabilities (Binnie Titchen 1999). Independent living can be specify as enabling independence by receiving the right accept how and when it is required (Morris 2004). It has now become a fundamental principle in various government policy documents much(prenominal) as the Valuing plenty today Strategy (UK De deviatement of Health, 2009) and the Personalisation through Person-Centred Planning initiative (UK Department of Health, 2010).This assignment aims to present a flesh out critique of a qualitative playing field en deed of conveyanced How adults with nurture disabilities view free living (Bond Hu rst 2010). A critique can defined as a balanced evaluation of the strengths and limitations of a look into article, in order to determine its credibility and/or applicability to rehearse (Gamgee 2006). This engage is a welcome constituent to the stream health and affectionate care research domain because whilst independent living is the preferred residential option, it is not at each clear whether it is suitable for all spate with accomplishment disabilities, moreover if thither is in fact sufficient empirical turn up to support this notion. It is therefore imperative to establish a sound licence base that draws upon the expectd personal experiences of those with schooling disabilities. Using an acknowledged frame form A ill-use by Step guide to critiquing a quantitative study (Coughan et al., 2007) the relative worth of the evidence in support of independent living will be judged systematically. As well as exploring the significance of independent living as an indwe lling treat intervention and its application to modern clinical practice.Ryan-Wenger (2003) suggests that in analysing create articles it is important to ascertain two fundamental aspects of a critique which can be subdivided into elements that influence the validity of the research methodology also knget as integrity variables and elements which influence the believability of the research such as writing flair, author(s), report title and abstract another(prenominal)wise known as credibility variables. The latter(prenominal) seems to be the most logical place to commence.Evaluation of the Journal ArticlePolit and Beck (2006) state that writing style should be such that it attracts the reader to read on this penning is well writ ex, comprehensive and concise. The structure and layout of the reputation is well organised with a logical consistency and free from jargon in comparison to nigh pennings where the author(s) can be opaque in their approach. However slight reservati on is reserved concerning the direct of proof reading as there seems to be some grammatical and typographical errors which can be found on pages 288 and 289. Both authors appear to father a sound background in learning hindrance from both a societal context and educational settings. As indicated in the acknowledgements the authors qualifications indicate that they get hold of a degree of knowledge in this field and this piece of research seems to be a part of a taught component of their masters programme.The report tile seems to be descriptive and succinct, although it lacks specificity of the research methodology utilize in the study. This can be very useful for others who are searching for this type of paper. Although the term qualitative research is mentioned under keywords the title itself could be more specific. As a result the report title is ambiguous and merely eight words in length. Meehan (1999) states that a title should be in the midst of ten to fifteen words long in order to clearly identify the purpose of the study for the reader.This paper presents both an affable and detailed version of the abstract, except are both helpful? The accessible grad includes information on the subject and the number of participants, whereas the detailed form provides an out birth of the methodology utilize, ethical framework, findings and recommendations. On balance the summaries present a clear overview of the study, however it does beg the question in what sense is the accessible form accessible? and to whom? It seems that the authors are trying to be politically correct rather than logical because how legion(predicate) service users actually read the British Journal of Learning Disabilities?. It seems that this is a knee jerk chemical reaction which has been applied incorrectly it would be more suitable if the document was aimed at informing an audience with learning disabilities such as Valuing People (UK Department of Health, 2001) which caters to a wide range of readers. The easy -read version is aimed at service users whilst the denser version is aimed at professionals and service providers. Having identified and analysed variables that affect the credibility of the research presented, how believable the work appears, the authors qualifications and their ability to undertake and accurately present the study. The robustness of the research methodology and the integrity of the findings will be appraised in order to determine the trustworthiness of the study and its applicability to nursing practice.The authors state the aim of the study is to explore the views of nine people with learning disabilities who live already achieved independence and wish to contribute to the contestation of independent living. The authors suggest that this style of living is now viewed as desirable, but what is the human race for people who live with learning disabilities? This concept of desirability is held as problematic by the authors who cho ose to study and present the reality of living independently as opposed to the notion of worldwide and conventional wisdom. A study conducted by Barlow Kirby (1991) concluded that people in receipt of self-directed support had more life satisfaction than those in residential care. This finding is further supported by the number of Independent Living (HM Office for damage Issues, 2007). The decision to suspend judgement about independent living is justifiable and is supported by other researchers in the field of learning disabilities as there are several implications for service users, professionals and service providers. This is for a number of reasons for instance promoting choice and control (OBrien, 2002), health issues (Priest Gibbs, 2004), vulnerability (Cooper, 2002) and the ability for those with learning disabilities to access services (Jansen et al., 2006).The writings review conducted by the authors demonstrates an appropriate depth and breadth of reading around inde pendent living. The volume of studies included are of recent origin world less than five years old the a few(prenominal) historical studies included put the concept of living independently into context. The authors successfully identified conflicts between the literature by comparing and contrasting findings (Burns and Grove., 1997), because although evidence exists to show people who have moved from larger institutions prefer littleer group homes (Forrester-Jones et al., 2002) there is still no accurate data detailing the number of people with learning disabilities living independently (Beadle Brown et al., 2004). However the authors failed to mention how they conducted their search and information on the databases used to gather papers in their review. The authors did however, use primary sources of information as opposed to secondary sources and anecdotic information, which attests to the integrity and value of the study presented.Bond Hurst (2010) ascertained the narrative s of nine people with learning disabilities via the use of semi-constructed audiences deep down their methodology. The authors are to be commended for their attention to detail in terms of their ability to design and structure interviews so as to accommodate the needs of the participants. As well as conducting interviews at time and venues convenient to them. The interview structure included open-ended questions to assist understanding as communication emerged to be a key barrier for some people with learning disabilities. The authors report on a number of theoretical issues that have been adapted for the participants in order that they might fully participate in the research process. The structure of the interviews was devised exploitation the Canadian Model of Occupational Performance (Canadian Association of Occupational Therapists, 1997), but is this model applicable to the United Kingdom population and to which care setting? Bond Hurst (2010) come aftered thematic analysis within their methodology in assessing the narratives. The data collected was audio taped and later transcribed into coded themes, which is acknowledged in superior general research literature to be good practice. On balance, the authors adhered to the steps in the research process and it is conveyed between the fluidity of phases.The critique subsequently moves onto considering the ethical framework. This research paper was supported by the local morals committee and all participants in the study gave informed consent. Although it is not clear whether or not it was an depicted object Health Service (NHS) ethics committee. However, the authors sought to hold back their working methods complied with the Data Protection Act (1998) but not with all government legislation applicable to the study such as the Mental Health Act (1983). Although there is mention about accessibility, the authors failed to ensure the participants had the capacity to make informed decisions as defined in t he Mental Health Act (1983). In relation to the number of participants, the sample size is small and therefore whitethorn not be reflective or wholly representative for all people with learning difficulties. Small samples are more credibly to be at risk of being excessively representative of small subgroups within a target population (Coughan et al., 2007). Therefore slight reservation is held as the authors did not mention whether they sought to remove overall bias by generating a sample that is likely to be representative and generalisable to the target population. Parahoo (2006) states that for a sample to truly reflect of the population it represents the authors must capture a probability sample. The participants in this study were recruited via convenience sampling using a third fellowship (Melton 1998) however several variables could have an affect on the sample which can lead to it being misrepresent such as the vast age range. The authors are to be commended however, i n their efforts to maintain the confidentiality of their participants by fling them the choice to provide their own pseudonyms.In the discussion the authors identified seven themes from their data analysis which reflected the views of all the participants and in turn addressed the aims of the study. Their findings supported the four key principles as stated in the Valuing People policy document, and ways in which people can be supported to achieve this includes increasing brotherly inclusion, increasing autonomy and choice for people and raising awareness of the vulnerability of those with learning disabilities. However the study also highlighted that the majority of participants struggled with the more complex aspect of living independently, such as money oversight and budgeting. The government has recently introduced Direct Payments as part of a nationwide transformation in social care services, which involves paying money directly to an individual in need to take control of the ir own support and care services. This initiative will aid finance management as it enables service users to have control over the care they receive and how they receive it. The majority of participants maintained that when comparing their current lifestyle of independent living to that of their previous lifestyle it was clear that they wanted to remain living independently.Application to clinical PracticeThis section will explore the significance of independent living as an all-important(a) nursing intervention and its application to modern clinical practice. Gates Atherton (2001) state that there is a need for evidence of effectiveness in health and social care. The most important aspect of being a practician regardless of ones vocation, is that collectively we as professionals seek the best evidence available on which to base our practice (Coughan et al., 2007). The evidence in support of independent living is exceptional and not entirely accurate, therefore when evidence is presented it should not be taken on face value. As Cullum Droogan (1999) put it not all research is of the same quality or high standard therefore as a learning disability nurse and social worker it is important being a care provider that although a paper has been published it can be critically appraised. This paper is of central relevance to our practice in ensuring that the lifestyles of people with learning disabilities are informed by valid and reliable evidence. This research paper adds value to the current literature available in support of independent living however caution must be expressed as it is not solely about living independently. The concept of independently living cannot be advocated for everyone each person is contrary and therefore require contrastive levels of support which will meet their needs. The publication of Valuing People (UK Department of Health, 2001) the key document that prompted a change in the way health and social care services operate. The pape r made Person-Centred Planning a central component of service reform, and outlined four key principles namely Human Rights, Independence, Choice and Social Inclusion (Mansell and Beadle-Brown, 2004). This means that people with learning disabilities should be valued members of society, treated with dignity and respect whilst having the same rights and choices as everybody else (OBrien, 2002). Furthermore, people with learning disabilities should odour empowered to take control over the care that they receive in order to plan and live their lives independently.Previously, people with learning disabilities were shunned apart from the community and susceptible to abuse. The Community Care Act (1990) was introduced as a result of both political and social changes in attitudes towards the treatment of people with mental illnesses. In line with Mental Health Act (1983) the aim was to remove the stigma associated with mentally ill people away from isolation towards social inclusion (Soci al Role Valorisation, Wolfensberger, 1983). But does independently living mean that you get social inclusion? Currently we are seeing a culture of people who require support being effectively excluded from society, waiting for the next support worker to cook their meals, help with personal hygiene and general cleaning. This is a downward spiral in our society which is putting a demand on our system. As a care provider in line with the General Social Care Council and the Nursing and midwifery Codes of Conduct (2008), it is our duty to advocate in the best interest of the client at all times but who is actually making the decisions?Bond Hurst (2010) highlighted how closely health was linked to independent living and that many of the participants suffered from chronic conditions such as asthma, diabetes and arthritis. Is it a case of compromising funding for services at the write off of overlooking health issues? It seems that the authors make a plausible case that people with learn ing disabilities are being seen as not a priority as they carry a disproportionate burden of health inequalities among our population. The reality for people with learning disabilities is far from the projected lifestyle of independence (Emerson UK Literature). It is a challenge to support people with learning disabilities, several factors need to be considered to prevent potential disregard. Jansen et al., (2006) points out the need to adopt integrated care approaches in treating those with learning disabilities. This will involve working with different agencies (interagency team working) and different types of professionals (multidisciplinary team working) in order to provide an holistic service to meet their needs. Current research shows that a disabled person is likely to be in contact with at least ten different care professionals in their lifetime (UK Department of Education, 2003). Issues can arise through out this time which may lead to lack of continuity and communication. Therefore, a sufficient amount of training and awareness is needed to ensure that all staff are qualified and skilled to ensure equity of service provision.When caring for patients it is essential as a practitioner to adopt the current best practice. To determine what this is one must be able to critically appraise evidence that is presented to them (Basset and Basset., 2003). This paper focused on the lived experiences of nine people with learning disabilities about the reality of living independently. In critiquing this paper, the authors successfully highlighted the importance of independent living as an essential nursing intervention however there were also some limitations, the most important being limited verification of the data. Furthermore the narratives of the participants were highly subjective and findings non-generalisable, thus the notion of independent living is not to be applied to all that have a learning disability, or vulnerable adults with complex needs. As recom mended by the authors, further accurate, reliable and valid research is needed that will add value to the evidence-base domain.Total treatment Count 2,452Excluding Headings and References