The purpose of the study was to identify the experiences faced by nurses in caring for culturally diverse adult patients in medical and surgical wards. The experiences would be used to know the challenges faced by these nurses and ways to solve them to be sought. The problem of the study lies in the lack of a research statement. For any survey being done a statement of the problem should be distinctively stated to inform the readers of what the study is about. (Greenhalgh, andTaylor, 1997).
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The literature review contains many articles that are relevant to the study. Articles touching on nurses experiences while caring for culturally diverse patience are well discussed. There are numerous studies done before that have been included with their main results given. However, there is little information of the approaches used in earlier researches, their main objectives and major findings are not given thoroughly as should be done in any research. There was good coverage of existing theories on how cultural diversity affects nurses’ work.
There are many current references with more than ten of them having been written in the last ten years, only two references written in the last five years and some more references written long ago. Such references show a good understanding of the subject and well planned background research. According to the literature review the difficulties encountered by nurses in a multicultural environment are known. The factors that influence nurses’ ability to offer quality care are also known. While overall nurses’ experiences are known for childbirth situation and for families of dying children, little is known about such experiences encountered with adult patients. This is the point of diversion from other literature on the matters of nurses’ experiences. The researcher should have expressed this from the beginning by suggesting that the study is intended to identify any similarities of experiences encountered by nurses between different patient groups. (Granehein, 2004)
The study is not explicitly expressed since one only gets the idea of what the researcher is upto by reading through all the literature review. It is hard to grasp why the researcher is doing the study while already so much information exists. The study is based on substantive theory because it gauges the interactions without going to the scientific procedures of identifying causes and effects. It is not tentative since there already exist a lot of information on the subject.
The study is unclear on relationships between causal factors and their interactions with a nurses’ experience which have not been expressed in the outline of the study. The planning of the study would help nurses working with culturally diverse adult patients know how better to render services to them. There had been no previous studies on this area and the findings would help the nursing training to be prepared for the challenges involved.
Research objectives identified are: identity experiences of nurses in caring for culturally diverse adult patients and to use such knowledge to find best solutions. This objective though is not explicitly stated. The objectives for every research done should be well stated as they act as a guide to both the researcher and the readers of the results. (Neill, 2006). Questions asked have not been clearly stated though some could be derived from the text.
Question on the respondents’ ethnicity, number of years respondent had worked with culturally diverse patients and formal education level reached in multicultural aspects. Another question the description of the experiences respondents had had with culturally diverse patients. There was no expressly stated hypothesis in the study. It can only be hypothesized that nurses have had to deal with unique problems when working in multicultural environments.
The main variables of the study were: role of cultural education in nurses’ work, the role of patients’ family to the work of the nurses, the effect of visitors, the role of other health workers in making nurse’ work easier or harder, the attitude of the nurses as they attend patients with different culture from theirs, the number of years of service and the role this plays in easing nurses’ work and the friendliness of the healthcare system to nurses.
Formal cultural education levels, the number of years of service, ethnicity of the nurse respondent are all independent variables. The attitude of the nurse is the dependent variable while the role of the health care system, role of family and other health workers are research variables. The dependent variable shows the attitude of the respondents towards cultural diversity. The aim of having independent and dependent variables is to indicate the influence of the independent variables on the dependent variable. Independent variable like ethnicity of the respondent will reveal stereotypical attitudes in the way respondents view the nurses.
Demographic variables identifiable in the study are ethnicity of the respondent, education level of respondent in multicultural affairs, number of years respondents had worked with diverse patients and number of family members for the respondent’s patients. The research design used is the completely randomized block design since the population is homogeneous. The factors that interact in this case are the ethnicity of the respondent and the number of years they had worked with culturally diverse patients, which may be considered as treatments for this design. The subjects were randomly picked from this design. It is mentioned that 70% of the patients were culturally and linguistically diverse suggesting that a prior survey had been done to assess the composition of the composition of the patients. The results of the pilot study were used to specify the requirements for the respondents.
To be included in the sample, respondents had to be registered nurses who had worked for five or more years with culturally diverse patients in the medical and surgical wards. The respondents were randomly picked depending on their availability. The sample size was 10.
A power test may not have been conducted as the researcher is silent on the issue. The researcher does not give the size of the population of nurses and the method used to come up with the sample. The percentage of the sample with respect to the population is also missing. This information is necessary since it ensures that the sample selected is representative of the whole population. (Spall, 1998).
The sample members were all registered nurses who had between 5 and 25 years working with culturally diverse patients. Sample attrition number is 5 which made 50% of the total population. These people did not wish to be contacted later in the study. The respondents sampled had to be asked to willingly participate in the study and a written consent was sought to call them latter on to confirm the end result Ethical consent was sought from two institutions that deal with research in human affairs.
The study was done by the investigator behind closed door while respondents were encouraged to relax and convey needed data. The setting was appropriate since such data was very sensitive and privacy was vital. The use of the numerical code helped in maintaining the privacy. This has the effect of assuring the respondent that the information they gave was confidential and thus would not hide a thing. This helps the researcher get the right information.
Several measures have been used for the study. The data from respondents was collected in an interview in which questions were asked. The level of education in cultural affairs most likely used a nominal scale as was ethnicity of respondent. The interview method was been used for confidentiality purposes and because the data to be collected was quite lengthy. The data required person to person exchange which is why an interview was opted for.
There is no information provided as to what measurement instruments were used by other researchers in their studies. We therefore have no way of comparing the advantages or otherwise of the interview method used in this particular one. The use of interview method for data collection is viable since other methods could break the privacy condition highly valued for success of this study. The data was collected in privacy mostly ward offices at the convenience of the correspondent. The interview took about an hour with all respondents’ comments being tape recorded and written. (Jane, 1995 and Wengraf, 2001).
The data was read twice and categorized according to specifications alluded to some researchers. This researcher failed to provide the mode of categorization used and did not defend its use, mentioning it was not enough.
This categorized data was coded into distinct units and defended it, mentioning it is not enough. This categorized data was coded into distinct units and authenticated by five of the respondents and other nurses. The researcher is also silent on how the analysis is left for us to guess. (Maxwell J).
The level of significance used for the study is not mentioned. It is doubtful if as all it was considered even before the commencement of the survey. The level of the significance guides the selection of a sample size and that it is not mentioned here raises the question of representatively of the sample. The study done by the researcher lacked clearly defined measurable variables which makes analysis hard. The statistical procedures are stated at the onset of the study at which time the statistic to be tested is also mentioned. To fill such a table as the one given would require the data to be given in numerical form. For the analysis to include relationships or differences data should be in numerical form. It is therefore impossible to use correlation analysis or ANOVA. Even t-test is used when comparing two set of categories which are clearly absent from the survey. Further the table cannot be filled in the absence of the results and therefore no interpretation of results would be done. The researcher did a qualitative research problem and thus the use of quantitative statistical procedures is not applicable. (Morehouse and Maykut, 1991).
The researcher presented the findings of the data in three categories. The presentation is orderly but what lacked the actual results. The researcher has however, clearly explained the effect of each factor on nurses ability to driver services. No limitations have been categorically stated but we can cite one in the unavailability of some respondents to confirm categorization during data analysis. Limitations of any study should be well stated and the implications thereof. The researcher generalized findings into categories and subcategories and explained them well.
The finding of the study identified the important role played by a patient’s family. It further indicated that nurses were handling big challenges as other health workers left the burden of caring for the culturally diverse to them. Nurses expressed the need for formal cultural education in their work. The study also suggested that cross cultural differences were not as bad. The study is poorly described. The researcher did not develop a clear research design from the start and replication is not possible. This is however expected of qualitative researches. (Creswell, 2003).
The findings of the survey suggest that the healthcare system should be made flexible to accommodate cultural diversity by availing interprets throughout. It also proposed development of cultural competence in nurses by training them on cultural practices. The study further suggested that research be done to assist in building better care for all patients regardless of their cultural background.
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