Discuss About The Cohort Identification Using Electronic Health.
At the end of the introduction and background section, purpose of the was clearly mentioned. Purpose of the study was mentioned after through literature survey. From the literature survey, it was evident that parental views were not explore on their children’s vaccination. Hence, purpose of this study was to explore the perceptions of parents on their child’s vaccination in Singapore to identify gaps in current healthcare practice and therefore help develop future programmes to improve parents’ experiences regarding their children’s vaccination (Kurup et al., 2017).
Interaction of nurse with parents during immunization and for immunization of children is crucial aspect. Nurse can play significant role in improving parent’s perception for adherence to immunization and influencing others for immunization. Nurse can reduce parents anxiety while delivering painful injection to their children and educating them and improving their knowledge about the immunization (Holland, 2014).
Parents perceptions like effect of vaccination on their child’s growth, issues related to vaccination, past negative experiences and religious beliefs were the risks associated with parents for the participation in the study (Kurup et al., 2017).
Risk minimisation strategy was not mentioned for the all the risks. Risk minimisation strategy was mentioned only for risk like issues related to vaccination. Most of the children might face problem during vaccination. Child might feel pain and might cry during vaccination. Authors suggested strategies to reduce risks. Strategies to minimize risk mentioned by the authors can be considered as valid strategies because these were mentioned with relevant literature support. Pain during vaccination can be reduced by using distraction techniques. Moreover, authors also suggested use of topical anaesthetics for pain management. However, there was no standardised anaesthetic is available for use during immunization (Kurup et al., 2017).
Written consent was obtained from the participants for voluntary participation and confidentiality of data. This written consent was taken individually after providing information related to study both in verbal and written format (Kurup et al., 2017).
There were no identified potential risks other than identified by the author.
Descriptive qualitative method was employed in this study. Descriptive study can be helpful in the describing the health-care and nursing related phenomenon. Qualitative research designs are being used widely for the gaining insights of the poorly understood phenomenon (Gray et al., 2013). Descriptive qualitative method can be useful for obtaining information in the form of description and in the form of interviews or questionnaires. In this type of descriptive qualitative analysis, usually thematic analysis being used. In this study, also thematic analysis was being used. However, care should be taken that it should get confused with the content analysis (Chesnay, 2014).
Was this choice suitable for the given research problem/question?
Qualitative research methods are being used for the comprehensive summation of the experience of the people related to particular phenomenon. Information related to patient experience can be gathered either through observation or interview. In this research study, information related to parent’s perception about their children’s immunization need to collected. This information was collected by conducting interviews of parents in person and through telephone. Moreover, this research method can fulfil the aim of the study. Hence, this research methodology is suitable for this research study (Morris, 2015; Bell, 2014).
In descriptive qualitative studies, data can be collected through different methods like interview using interview guide, surveys, observations and filed notes. In this study, data was collected through interview using interview guide. Suitability of the interview and interview guide was confirmed by carrying out pilot study. There were two types of interviews like structured and semi-structured in which closed and open questions can be asked. In open questions, fixed information can be obtained and in closed questions, variable information can be collected based on the individual participant. Both structured and semi-structured interviews can be used effectively for collection of data in qualitative research (Fisher, 2011). In this study, semi-structured interview was conducted. In this study, both face-to-face and telephone interviews being used. Each interview process was lasted for about 10-30 minutes. These interviews were audio-recorded. These audio-records of the interview can be useful in demonstrating more details of interview, accurate analysis and monitoring of the interview process. Moreover, these audio-records can be achieved for later reference. Outcome of the interview based qualitative study based on the sampling of the participants because participants need to express their feelings and experiences. Content of the interview is important aspect because it should align with the aim and purpose of the study and outcome of the study also based on the content of the interview questions. Content which is interview guide in this study can be considered as robust and valid resource because it was developed based on the literature and two experts opinion were taken. However, details of the experts like expertise and experience were not mentioned in this study (Morris, 2015; Erlingsson & Brysiewicz, 2013).
In interview based data collection, accurate demographic data can be collected because participants can not give false data related to age and gender. In interview based data collection both verbal and non-verbal ques can be obtained from the participants. Level of knowledge and comfort level in expressing it can be easily assessed in interview based data collection. Specific information can be collected by avoiding distractions in interview based data collection. Interview based data collection can be helpful in assessing emotions and behaviour of the participants (Levickis, 2013).
Collected data should be blinded from the participants. It can be helpful in reducing biasness in the data collection and also can helpful in improving rigour of the collected data. Participants were recruited at the start of the start by considering inclusion and exclusion criteria (Isaacs, 2014; Braun et al., 2014). Recruitment of data in the later phase of the study until getting saturation of data can result in the recruitment of participants with variable characteristics. It can result in the collection of variable data. There were less chances of biasness in this study because data was collected by one senior researcher who was not part of the intervention to the children. Moreover, variability in the data collection was reduced by employing the single researcher for data collection. All these factors helped in improving trustworthiness of the research findings (Fisher, 2011).
In this study, 22 participants were recruited; however, data was collected for 19 participants. One participant was participated in the pilot study and two participants were withdraws due to scheduling constraints. No of participants could have been mentioned in the sampling section of the article; however, it was mentioned in the data collection section of the article.
Sample universe can be effectively defined and decision making in sample selection can be improved by incorporation of inclusion and exclusion criteria in the sample selection. Variability in the outcome of the study can be reduced and robust and valid data can be obtained by considering inclusion and exclusion criteria prior to initiation of the study. The inclusion criteria included a parent who: (i) had a healthy child aged 0–18 months undergoing vaccination, (ii) was the main caregiver of the child and (iii) was able to speak and read English. The exclusion criteria were parents who had: (i) visual and/or hearing impairments and/or (ii) cognitive impairment (Kurup et al., 2017).
In this study, purposive sampling method was used for the recruitment of the participants. In this purposive sampling method, recruited participants would be specific purpose. In this study, participants whose children would receive immunization and these participants would express their perception. These participants were recruited from different ethnic groups. Inclusion and exclusion criteria were considered prior to recruitment of participants. Initially, 44 participants were approached for participation. Out of these 16 were unwilling to participate in the study and 6 participants didn’t met inclusion criteria. 22 participants were recruited in the study; however, data was collected from the 19 participants (Kurup et al., 2017).
This study was conducted in an immunization clinic in Singapore. In this clinic school going children used to receive vaccines.
Most of the participants exhibited adherence to redocumented vaccination schedule and also took up optional vaccination schedule.
Parents exhibited trust in the Government and healthcare sector regarding vaccination. It helped in improving their trust in the in vaccination and standard practices of administration of vaccines. These participants mentioned positive aspects like preventive measures of vaccination for their children and community against disease.
Participants stated that vaccines are easily available at the affordable prices, freely available and with relevant subsidies.
Most of the participants adhered to vaccination due to fear of possible revaccination to their children and possible adverse effects of occurrence of diseases due to non-adherence to vaccination.
Few of the participants mentioned negative aspects of vaccination. Few participants delayed vaccination schedule and didn’t take optional vaccination. These participants mentioned various reasons like impact of vaccines on their child’s growth, issues in administration of vaccines, past negative experience of vaccination and religious belief for delay or split in vaccination. These participants delay or split vaccination due to possible allergy, fever, pain and crying.
Some participants scheduling constraints as the reason for their non-adherence for vaccination because it was difficult for them to maintain balance between work balance and vaccination schedule.
Few of the participants avoided optional vaccination because its non-availability and less severity of the disease.
Participants well fed their children and considered homeopathies for preventing adverse effects of vaccination.
Participants took part in vaccination process by handling the child and observing the vaccination procedure.
Parents used distraction techniques to reduce pain and crying due to vaccination.
Participants mentioned that waiting time as the drawback for vaccination and instant messaging helped them in reducing waiting time for their vaccination.
Participants had differing opinion regarding amount of information about vaccination. Few of the participants had sufficient and remaining had insufficient information regarding vaccination.
Few of the participants were satisfied with the knowledge and services of the healthcare providers related to vaccination. However, participants were not satisfied with knowledge and services offered by healthcare professionals (Kurup et al., 2017).
This study was conducted at single healthcare setting. Hence, generalized applicability of these findings is difficult. Information related to perceptions of the parents non-English speaking parents were not collected in this study. This study considered parents with children between 0 – 18 months. Hence, information related to perceptions of parents with who delayed vaccination beyond 18 months was not collected (Kurup et al., 2017).
Outcome of this study could not be considered as evidence because study outcome can be considered as evidence because if large scale study was conducted at different locations. Outcome of this study can not be considered for parents with low socioeconomic class and less educated people (Harreveld, 2016)
Personal ideas, experiences or knowledge (bias) can influence findings. It can also impact data collection and analysis because in qualitative studies subjective data should be collected. Personal bias can influence collection, analysis and interpretation of the subjective, in case data is not being blinded or coded. It can lead lessened transparency in the in the data collection and outcome. Hence, it may reduce validity of the results (Smith and Noble, 2014).
According to levels of Evidence pyramid, reported results in the paper are of level VI.
These results can not be used as evidence-based practice because this study was conducted at the single site and very less participants were incorporated in this study. Moreover, rigour and biasness were not mentioned properly in this study. Rigour and biasness are the most important factors for considering these study as evidence-based study (Dean et al., 2016).
Prior to this, I had knowledge about the immunization safety to children and women. It is evident that immunization procedures are painful to children and it can produce anxiety, distress and fear in children and their parents. It is mainly due to fear due to needle pain, parental nonadherence and avoidance of medical care. Reduction in pain and distress during vaccination can be helpful in reducing fear of needle, needle phobia, noncompliance with scheduled immunizations, and later avoidance of medical care (Faucette et al., 2015).
This information was gathered from internet sources, clinical online databases, professional organisations. Most of the information was gathered by discussion with colleagues. Through these discussions, along with getting information, analysis and interpretation of effect of immunization on children and their parents was done. These decisions helped in clinical decision making and it helped in augmenting confidence of me. Medical textbooks also proved rich source of information. In medical textbooks, case studies were mentioned and these case studies helped in getting information related to diverse aspects of immunization like benefits of immunization, adherence to immunization, parents perceptions and barriers to immunization. PubMed Clinical Queries in National Library of Medicine was used for getting information. Different databases like Pubmed, PsycINFO, Web of Science, or CINAHL were used for gathering information. Disease registers in the hospital, health surveys and clinical trials data were also used to collect information related to immunization in the children (Liu et al., 2013).
In pregnant women, there is possibility of alteration in the immune system. Due to alteration in the immune system, these women are more susceptible for vaccine-preventable infections. Immunization can be helpful in protecting these women from vaccine preventable infections and in this process foetus also get protected. Immunization can protect the foetus and infant through specific antibodies transferred from the mother during the pregnancy. Morbidity in pregnant women and her foetus can be effectively reduced through vaccination to pregnant women (Marshall et al., 2016). I feel there should not be question regarding safety of vaccine because vaccine undergoes several safety and effectiveness tests prior to its approval for marketing. Few of the children after taking vaccination might exhibit adverse reactions like redness, pain, or swelling. These reactions would be minor and these can disappear in few days. I have opinion that vaccines are safe and effective because vaccines were being giving healthy life to millions of people including children (Kochhar et al., 2017).
I learned that vaccine administration is associated with few of the drawback like pain to the children and minor adverse reactions. These drawbacks can be easily managed. In comparison to the wider benefits, these drawbacks should be considered. Nurse and parents role are very important in effective immunization to the children. Nurse need to understand perceptions of parents regarding vaccination to improve their adherence to immunization. Immunization should be considered safe in children and pregnant women because evidence is available for the safety of immunization through large scale clinical trials (Jones et al., 2016).
References:
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