NURS4301 Health Research Methods

What is the review purpose, objective, or question?

The main objective of the research is conduct systematic review for identifying as well as synthesizing studies of qualitative nature in respect of frontline nurses’ challenges and experiences while patient care for COVID-19 patients. It is vital to understand the nurses’ experiences as they are among the most vital healthcare workers.

Was there a published protocol for this review? If yes – please provide the reference and the PROSPERO registration number (if registered).

The published protocol for this review shows funding as none, with no conflict of interests prescribing PROSPERO registration number as CRD42020207477. It is a part of International Nursing Reviews.

What are the eligibility criteria (inclusion and exclusion criteria) for this review?

The study included a qualitative systematic review for conducting thematic analysis, five data based such as PubMed, Ovid, Web of Science, CINAHL, as well as PsycINFO were used, with reference to the searching criteria between January to Mid-August 2020. Out of these, 25 abstracts were screened and considering the inclusion criteria 9 studies were included. Also, five themes were identified with regard to the barriers to COVID-19 care by 133 hospital-based nurses.

What types of studies were included in this review?

The study included has the following traits, empirical primary studies having research design based upon qualitative method, having their focus upon registered nurses providing direct care to the patients with COVID-19 in hospital-based settings, also the perspectives and experiences of patients with COVID-19 are also considered. Further studies published in peer-reviewed form and in English are included only and are either published, or republished during January and August 2020.

What databases/search engines were searched in the review?

The search engines which are used in the review are PubMed, Ovid, Web of Science, CINAHL, as well as PsycINFO which helped the researcher to conduct the study in effective manner by inculcating several keywords and headings.

Were the search terms suitable for the purpose of this review? Provide a rationale for your answer

Yes, the search terms are quite suitable for the purpose of the review. The following Medical Subject Headings (MeSH) and keywords are used, nurse or frontline nurse; and qualitative research, qualitative study, interview; and COVID-19, or SARS-CoV-2. Apart from it, several other additional terms were also used, perception, barriers, or challenge; experience, or ethnography, or phenomenology; or pandemic, perception or patient.

What search limits were applied?

The search limits that were applied are using key words and the publications were articles being published within January and August 2020. Thereafter articles are required to be peer reviewed or in English.

Does the PRISMA flowchart adequately describe how articles were identified, screened, assessed for eligibility, appraised, and selected for inclusion in the review?

PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) is a reporting standard for Systematic Reviews that gives recommendations on how to describe the findings of systematic reviews and meta-analyses. For reporting systematic reviews, the PRISMA Statement offers a minimal set of requirements. It includes a list of things to include in the report, as well as a flowchart. According to the research criteria, the PRISMA flowchart properly depicts how articles were discovered using the search technique and subsequently how they were selected, analysed, and included in the study. The first search turned up 81 publications. Only 25 studies were left after the abstract review after EndNote X9 was used to eliminate 32 duplicates and 24 studies were discarded by looking at the title in EndNote X9. Among these, 15 papers were selected for a thorough text-based examination; three were discarded because the participants weren't nurses, and two others weren't included since their purpose didn't match the study's goals.

What critical appraisal instrument(s) was/were used to determine methodological quality of the articles? Were these instruments appropriate?

The Critical Appraisal Skills Programme Qualitative Research Checklist (CASP) was used to assess the methodological quality of the research under consideration. It was determined that the critical evaluation tool was effective in identifying the methodological quality of the papers, and that a full systematic review based on theme analysis could be conducted. The checklist consists of ten questions that pertain to evaluating the study's objectives, including qualitative design, recruitment of the research design, data analysis and synthesising crucial information, and generating conclusions from the study's findings. The quality evaluation was carried out separately by the first and second writers, and the findings were then compared. Consequently, the research contains nine publications that have been carefully chosen for their methodological rigour. As a result of the effective deployment and assessment of the important components of the research issue, it is possible to make the required connections between the study and other fields.

Discuss if the included studies are summarised adequately? (Study design, study population, location, interventions, outcomes, results)

The included papers are well summarised, addressing both the study design and population as well as the conclusions. In this research, topic synthesis was used. An analysis of qualitative research to discover common themes and implications for future practise. A qualitative systematic review framework comprising participant, condition of interest, setting, and result was used in this study (PICO). To ensure that the viewpoints of people handling COVID-19 patients are heard, frontline nurses working in hospitals were interviewed. There are various uses for this study, which includes research from 10 locations and 4 nations. With the outbreak of COVID-19 came new obstacles for frontline nurses on the psychological, social, and physical fronts. The nine investigations started in hospitals in four countries. This study is the first to look into COVID-19 nurses' difficulties from a qualitative perspective. Early on in the pandemic, nurses faced personal and systemic challenges. Administrators and nurse managers may use the review's results to support COVID-19 patients' nurses.

Are excluded studies listed with reasons for their exclusion?

Yes, the excluded studies were listed with reasons for their exclusion as the studies focused on or including the opinions so raised, experiences of the challenges so faced by the non-nurse healthcare providers, or the same belonging to care for other pandemic diseases or respiratory diseases apart from COVID-19, further, studies that were published in language other than English were also excluded as they did not meet the aim of the systematic review to be conducted.

How was the data abstracted and synthesized?

With respect to the data analysis, the first author created a narrative and summary table, while the second author reviewed the table for accuracy, and with respect to the data synthesis, in three phases, the thematic synthesis was carried out for extracting the clear qualitative data. The same has been undertaken on common consensus of the author.

Is there adequate critique of the studies reviewed, including discussion of study limitations?

Yes, the adequate critique has bene provided within the studies so reviewed, and also the limitations clearly prescribe which areas are not being included in the research. It also described the future scope of the research, which areas of improvement are there in regard to this research. Also, detailed criticism has been carried out with regard to the criteria for countries, exclusion criteria for one article being misappropriated. Further, this study focused on obstacles to practising nursing have also been depicted. There may be a tendency to report unfavourable findings from the original research if this is the case. Searches done in August 2020 were used to include the studies in this evaluation. COVID-19 knowledge is fast evolving, despite this review's inclusion of pre-publication studies. There is a possibility that new qualitative research on the condition was published while the paper was being written. Also, the language related limitation of article being in English was also depicted.

What is your assessment of the level of evidence included in this review (JBI hierarchy)?

This review contributes to evidence-based nursing in a number of ways. For the first time, a comprehensive analysis of the difficulties that nurses have when caring for patients with COVID-19 has been conducted. COVID-19 is the most common infectious illness in decades, despite the inclusion of earlier pandemic responses in certain research. The disease as well as the virus which causes it should be the focus of research. To ensure that the voices of those treating COVID-19 patients are heard in this review, it includes research that interviewed frontline nurses working in hospital settings. This evaluation, which includes studies from 10 cities and four countries, is anticipated to be suitable for a wide range of situations. A fresh understanding of the psychological, social, and physical hurdles faced by frontline nurses during the COVID-19 outbreak is also provided by this research.

How should the information from this systematic review be applied in clinical practice (knowledge transfer)?

Policymakers in the fields of nursing and healthcare should increase research funding. With regard to COVID-19, long-term research is particularly important. Improved nursing practise and improving health care can only be achieved via research. Frontline nurses who care for patients with COVID19 have unique challenges, which nurse supervisors and healthcare executives must take into consideration. Their psychological, psychological, and physical well-being is at jeopardy. Nurses, on the other hand, require timely access to relevant information. Creating a clearinghouse that summarises the most recent findings, which should be audience-directed, as well as actionable is a necessity for healthcare policy makers.

Bibliography

Joo, J.Y. and Liu, M.F., 2021. Nurses’ barriers to caring for patients with COVID?19: a qualitative systematic review. International nursing review, 68(2), pp.202-213.

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