Running Head: QUALITATIVE RESEARCH ARTICLE CRITIQUE

Qualitative Research Article Critique By Karyn Neal University of South Alabama

A paper Submitted in partial fulfillment of the requirements for Nur 404, Evidence Based Practice Informatics University of South Alabama

Spring 2013

Running Head: QUALITATIVE RESEARCH ARTICLE CRITIQUE

Author: Ingrid Ruud Koutsen, Laura Terragni, and Cristina Foss Title: Empowerment and Bariatric Surgery: Negotiations of Credibility and Control Journal: Qualitative Health Research Year: 2012 Volume: 23 Issue: 1 Pages: 66-77

Statement of the Phenomenon of Interest In the article Empowerment and Bariatric Surgery: Negotiations of Credibility and Control , the authors outline a qualitative interview with patient, diagnosis as morbidly obese in an empowerment program which worked on the individuals identity. The phenomenon of interest is clearly identified. Obesity is an epidemic in todays society. In an aim to help the patient develop responsibility for the weight an empower program was developed. This phenomenon required a qualitative format because, there is little empirically based knowledge about the empowering progress in relation to health promotion. The foundation of the research has been described. In Norway, an extensive treatment program in patient diagnosed as morbidity obese was implemented in 2005 (Knutsen, Terragni, & Foss, 2012). The aim of the program was to empower participants to improve health and reduce morbidity. The research in this article gave a better understanding of structure of empowerment in modern-day health practices. Purpose The purpose of this qualitative study is implied in the abstract and introduction, and it is also clearly stated in the Methodology section of the report. Here, the authors states

Running Head: QUALITATIVE RESEARCH ARTICLE CRITIQUE that the purpose of the research was to focus on, how an empowering program for

patients diagnosed as morbidly obese worked on individuals identity (Knutsen, Terragni, & Foss, 2012). Practically as noted in the abstract, the focus of the study rest primarily on an, explicit aim to empower patient to take responsibly for their health (Knutsen, Terragni, & Foss, 2012). By examining the effects of empowerment the authors explore the effects of empowerment on the participants, in an effort to improve health and reduce morbidity. While the goal of the qualitative research is not to general all obese patient weight loss process, it ought to be clear that the finding reported in this article are indeed transferable in other situation of health care promotion empowering approach. Method The study was qualitative and was within the framework of the analysis. The data source was used from interviews with the patient diagnosed as morbidly obese who took part in the treatment program. The authors flowed ethical guideline of , the Helsinki Declaration and the study was approved by the Regional Ethics Committee and the Norwegian social science data service (Knutsen, Terragni, & Foss, 2012). Sampling The participants selection was congruent with the study. There was a purposeful sample of patients that were diagnosed as morbidly obese, which of whom had applied for weight-loss surgery. A nurse employed at an outpatient clinic for the obese helped recruit participants (Knutsen, Terragni, & Foss, 2012). Nineteen patient were invited to participate in the study, only 9 respondents who underwent the bariatric surgery accepted by returning the informed consent. The sample consisted of 1man and 8 women between 37 and 56 years of age. All of the participants were Norwegians. The research article

Running Head: QUALITATIVE RESEARCH ARTICLE CRITIQUE described the participants in terms of marital, education, and employment status. Data Collection

The data collection was a direct focus on morbidly obese humans. The research article described the data collection strategies. The authors met with each participant individually, five times for interviews during the treatment process. The venue was selected according the participators preference. The first interview took place before the respondents entered the program, the second was held after the course in life style change, the third 2 weeks after gastric bypass surgery, the forth 2 to 3 months after the gastric bypass, and the fifth 9 months after the gastric (Knutsen, Terragni, & Foss, 2012). A qualitative interview was conducted to promote open communication between the respondent and the interview. During the initial the respondent were asked to elaborate on their personal experience with obesity, how they felt they become obese, how they viewed themselves, and why they joined the program. The interviewer remained the same during the coarse on interview, this allowed the respondent to develop a relationship with the interview and become more comfortable and relaxed. The interviewer emphasized reflectivity during the series of interview, to stay on task. The interviewer was not obese and had to reflect on personal judgment toward obesity, this may have effected the course of the interview. Data Analysis The researcher record and transcribes the interviews word for word. Authors did not put word in the participants mouths, there are actual quotes from the participants throughout the entire article. The author includes all statements, even the statement which are not congruent with the theme of the study. The analysis of the data collected for this study

Running Head: QUALITATIVE RESEARCH ARTICLE CRITIQUE appears to be clear and explicit. The three major criteria for critiquing qualitative research, credibility, audit ability, and fittingness, are all evidenced in this study. Credibility

The participants embraced the experience as their own. The respondents credibility is a recurring theme during the timeline of the weight loss program. The respondents spoke about other individual negative judgment of the appearance and body size. During the weigh loss the respondents explained how shame was left and replaced with a new life. The respondent experienced anxiety Auditability After reading and reviewing the authors research, I believe that another researcher could arrive to a conclusion parallel with that of the authors. The authors have a well documented timeline to the research process. Fittingness Throughout the study the was use of personal quotes for the respondents, anyone reading the article could clearly understand the data and draw their on conclusion of the research.

Findings The finding of this report bring the whole research process and theme of the article full circle. Through the different stages of the weigh loss program, there where struggles and contradictions.

Conclusion, Implications, and Recommendation As the reader I felt the conclusion did reflect the studys findings. The research questions

Running Head: QUALITATIVE RESEARCH ARTICLE CRITIQUE

were answered as a result of the study. There were other articles which branched off of this particular study, from different themes and angles. This article focused on the respondent in there last two stage of the weight loss program. The stages were, the bariatric surgery stage and the aftercare stage. In reading this article I felt as though the program did a great job to instilling empowerment to the respondents. However, after the gastric bypass surgery the respondents even though they understood this was the peak of the weight loss program, they felt a lack of control. The respondent mental health was in constant conflict, from feelings of shame from needing invasive surgery to feeling of happiness at the reduction of weight. I feel that the relationship between these issues of the empowerment process need further research. The interview confirmed the obese individuals even though they had surgery to alter their outer physical self, that they needed to learn to cope with internal conflicts of control. The researcher did not make explicit the direct relation of the study to nursing, although as a nurse I have a better understanding of the struggle and control factor in an obese individual. On a whole , I found the authors conclusion to be very vivid in explanation. My conclusion in that selfdiscipline and self-control, must be established before any empowerment program is introduced.

Running Head: QUALITATIVE RESEARCH ARTICLE CRITIQUE

Reference

Knutsen, I. R., Terragni, L., Foss, C. (2012). Empowerment and Bariatric Surgery: Negotiations of Credibility and Control. Qualitative Health Research, 23, 66-77. dio: 10.1177/1049732312465966. Retrieved from: http://qhr.sagepub.com/content/23/1/66