Zaman Et Al. (2014) With a Goal

Zaman et al. (2014)

With a goal of identifying which socioeconomic variables predict TB treatment outcomes, Zaman and colleagues (2014) compared a number of socioeconomic variables using the Chi square test. This was not an appropriate choice for the categorical variables of treatment motivation, treatment delay, and distance from a directly-observed short-course therapy (DOTS) center, because the sample size was too small for several of the comparisons. A more appropriate test would be the exact test of goodness-of-fit or the Fisher's exact test. The significance values were such that type I and II errors were probably avoided, with p values of 0.97, 0.0096, and 0.0003, but effect sizes were not discussed and p values appeared to be used to indicate effect size, a common error. Missing values were included as categorical variables. The authors made extensive use of tables to present the data using exact patient counts per variable, which rendered it amenable to meta-analysis and evidence-based practice implementation.

The discussion section was brief, but the authors did discuss and interpret all of the major findings (Zaman et al., 2014). Causal inferences were based on statistical associations and appropriately justified using patient reports and the findings of other researchers. The interpretations are generally well-founded and within the study's limitations, but undermined by the statistical errors; therefore, the generalizability of the findings may be limited. The authors did not discuss generalizability, but made the assumption that the data accurately described risk factors for poor treatment outcomes. A discussion of implications centered on compensating for weaknesses in the DOTS strategy, including the distance between patients' homes and DOTS centers, which was reasonable and complete. Overall, the report is well-written, organized, and sufficiently detailed to permit critical analysis, and is therefore accessible and valuable to practicing nurses. All of the authors are clinicians or scientists, which lends credibility and validity to the findings.

Qualitative Results, Discussion, and Global Issues: Carlsson et al. (2014).

The qualitative study by Carlsson and colleagues (2014) provided a clear and easily understandable analysis of the phenomenon of interest, which was the experience of nurses treating TB patients in Burundi. The categories and subcategories which emerged from the data were clearly described and supported adequately by interview excerpts. The themes directly addressed the purpose of the study and yielded an appropriate product. For example, food insecurity was a major concern of nurses because TB medication administration increased appetites among the poverty-stricken. Such insights should prove valuable for policymakers interested in increasing the effectiveness of TB treatment programs in Burundi and similar nations. Overall, the Results section provided a logical pattern of treatment issues identified through nurse interviews, thereby creating a convincing and integrated whole. No figures, maps, or models were presented, but a table listing the categories helped summarize conceptualizations.