Self Determination in the Elderly

The researchers found that the studies program does in fact have an influence on the students’ perceptions. TOPIC CONTENT This article was published on March 15, 2008 in the Journal of Nursing Ethics. The topic discussed is whether Nursing Student’s perceptions of the Elderly would change after being given an Ethics course. The article falls within the bounds of the journal as this is a publication centering on Nursing Ethics, which is clearly the subject of the periodical itself. No masthead description is attached to the article. STYLE The manuscript does conform to APA style in its major aspects.

Each page of the journal does contain a page header; however it alternates with the author’s name and the title of the publication. All information is cited correctly using footnotes. The structural differences in which the paper deviates from APA style is the lack of a Title Page, and variation in formatting. Instead of the four major sections being shown as Title Page, Abstract, Main Body and References, the paper is organized as a Research study in the format of Introduction, Background, Aims, research questions and hypothesis, Method, Analysis, Results, Discussion, Conclusion, and References.

INTRODUCTION

The beginning of this article concisely describes in two paragraphs the nature of the study. The introduction serves its purpose by highlighting the importance of patients’ self- determination as a crucial value to grasp in nursing. The first paragraph identifies the ever growing need of nurses who understand this value due to the boom in older patients. In the second paragraph, the author points out the problem which is the basis for the research study: that although the need for care is increasing, a less than favorable perception of working with these older patients exists with many nursing students, and practitioners.

The writers further bring to light the need for action by defining this as an ethical problem. To solve the problem and conclude the introduction, the writers bring in this idea of a study geared to indentify the impact of ethics education on the topic of nursing students’ negative attitudes towards gerontology. An explicit hypothesis is stated in the Method section 1. It reads “In this study, we set a hypothesis that the content in nursing studies would have a positive effect on nursing students’ perceptions of self determination in elderly patients in long term care settings. The origin of this hypothesis has not been made explicit however has been linked to research evidence during previous studies on the same topic. For example “studies have also demonstrated that gerontological content can have a Self-determination in the elderly 3 positive effect on student nurses’ attitudes towards older patients. ” The hypothesis was correctly derived from the theory cited.

METHOD The method is so described that a replication is not possible without further information. The setting is given as “the nursing ethics course offered at the nursing college during the time of data collection. The exact location of the school or the name of the course is not given. If this information is granted however, it is likely that the study would be replicable. The instrument used was a modified self-administered questionnaire that the new researchers would once again have to take into consideration when replicating the experiment. The researchers found this study to be accurate and they themselves will be replicating the study to “investigate further any changes that can be identified in student nurses’ conception of the self determination in older people in Finland”.

The subjects were not sampled randomly from the population to which the results will be generalized. The sample has three inclusion criteria; being a student nurse, having undertaken theoretical studies in geriatric nursing, and undergoing a period of clinical training in geriatric nursing. Informed consent was obtained by participants of this research study. The respondents were “informed about the voluntary and confidential nature of the data gathering and analysis”.

The probable biases in sampling that exist are that the sample content is highly skewed because 90% of the 120 subjects used were women. The controls used for experimenter influence and expectancy effects were that the questionnaire was administered to the participant anonymously, they filled it out on their own, information sessions were organized for the students by the researcher and students were given oral and written information about the study. In addition, pilot testing did not show any reason to revise the questionnaire.

Special variables affecting the subjects that were not part of the experimenter manipulation were participant variables such as age, ethnic background, gender, and experience in the nursing field. According to studies, “ nurses who have previous experience working with older adults have been shown to be very positive about their work and limited experience, young age, and being male were factors for showing less favorable feelings towards elderly people. The control groups were appropriate.

The subjects in the pretest group served as the control group. They were given the questionnaire, before taking the ethics seminar to see what their raw attitudes elderly patients and self-determination were. Then the variable of the ethics seminar was introduced and the effect of the independent variable- the seminar, on the dependent variable-the attitudes of the students, was measured. Three different studies were organized. Using the first study as an example, the following is how validity and reliability were established.

This study was the nursing students’ perceptions of elderly patients’ willingness to Self-determination in the elderly 4 exercise their self determination. Utilizing Cronbach’s alpha, which is an internal consistency measure or reliability, the researchers calculated the correlation of willingness to exercise their self-determination with the following other variables: receiving information on their own care, to be asked for their permission for nursing interventions, to exercise their right of refusal during care, and to make decisions about their own care.

The overall alpha value in the pre-test of the extent to which elderly patients are willing to exercise self determination was 0. 63 at pre-test and 0. 77 at post-test, with an increase of 0. 14. 11. This shows a reliable level of internal consistency, and that the ethics seminar increased this reliability level. To measure construct validity we must consider the adequacy of the operational definition of variables. The study has face validity.

It is measuring what it is supposed to measure; the perceptions nursing students have towards the elderly self-determination level. The research shows a predictive validity that is stronger as far as nursing student’s knowledge on the self-determination of their elderly patients. The study revealed that after the seminar more students thought that elderly patients had good opportunities to control their treatment, limited willingness to exercise their self-determination, and more of a perception on whether the elderly had any insight into their own medical treatment.

The numerical values are not explicitly stated but the study does say “our results confirm earlier findings related to positive attitudes towards elderly patients” 13 (356) The measures are free from biases regarding how the questionnaire was set up, every person given the questionnaire had the opportunity to ask a researcher if there was something they did not understand.

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