Surveillance of influenza-like illness

Part 1 (Quantitative and Qualitative Research Review)
Choose two scholarly, peer-reviewed articles about research studies.
Part 2 (Summarize Research Articles)
Write a summary of each of the articles that you identified in part 1.
Part 3 (Critique of Research Studies )
Complete a critique of the quantitative and qualitative articles that were submitted in part 2.
Part 4 (Critique of Research Studies)
Part 5
When turning in the final submission, please put in the following order: Quantitative Article Critique,
Qualitative Article Critique, References (should include the two articles, the text, and any other
additional sources).

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Part 1 (Quantitative and Qualitative Research Review)
In my quantitative research review, I chose a peer reviewed journal titled ‘Surveillance of
influenza-like illness in Belgian nursing homes’ while for the qualitative research review, I chose
‘Pre-exposure Prophylaxis in substance abuse treatment: a qualitative study of treatment provider
perspectives’ as my topic from a peer reviewed journal.
Surveillance of influenza-like illness in Belgian nursing homes is a quantitative research because
it was conducted upon measurements which are numerical and it tends to use research indicators
and tools which are statistical. From the journal, it is evident that a quasi-experimental approach
was used to conduct the correlation survey where numerical data was collected twice a month for
a 5 month period recording 10 observations for each participant. Data was collected using
questionnaires and a surveillance contact person was chosen for all participating facilities. The
research was objective whereby the researcher set the aims of the study before conducting it. The
research study is conducted at a level of precision whereby the validity and reliability of the data
was ensured before the analysis of the data collected. A quantitative research tests a hypothesis
as well as proving a theory. From this study, data was collected to measure the incidence of
influenza like illness in nursing homes in Belgium during the 2009-2010 season of influenza.
Comparative quantitative data was also collected on the coverage of vaccination for A
(H1N1)2009 and seasonal flu and it was compared to another data collected to show the lack of
influenza like illness among health care workers in nursing homes during the same observation
duration. This article was obtained from the following journal Archives of Public
Health 2010, 68.100-108. The choice of the article was due to its quantitative approach and it
was also proof of evidence based practice in nursing. The article can be found on this link:
http://www.archpublichealth.com/content/68/3/100.

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Pre-exposure Prophylaxis in substance abuse treatment: a qualitative study of treatment provider
perspectives is a study topic conducted through a qualitative design. The research develops a
theory since its main objective is to examine substance abuse treatment providers’ views on
engaging clients in pre-exposure prophylaxis. During the data collection, semi structured
interviews were qualitatively conducted on a purposively selected sample of 36 medical and
counseling service providers in 6 New York outpatient substance abuse treatment programs so
as to fulfill the assumption that the researcher is part of the research. The data analysis conducted
involved content analysis to show themes and trends in the data and coding was done
independently by 3 coders. This article was obtained from the following journal Substance Abuse
Treatment, Prevention, and Policy 2015, 10:1. The choice of the article was due to its qualitative
approach and it was also proof of evidence based practice in nursing. The article can be found on
this link: http://www.substanceabusepolicy.com/content/10/1/1.

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Part 2 (Summarize Research Articles)
The summary template of the quantitative research review includes the following sections;
Title
Surveillance of influenza-like illness in Belgian nursing homes’. This article was published in
volume 68 of the public health journal in 2010 from pages 100 to 108. The article was authored
by Jans, Latour, Broex and Catry. This is a summary of a quantitative study conducted to
compare treatments among groups following a quasi experimental research design.
Problem Statement
The researchers state that elderly people are severely affected by the presence of several risk
factors that influence the severity of an influenza infection according to previous studies.
According to the world health organization, vaccination for the nursing home staff who come to
close contact with the sick population is an important tool in trying to contain influenza-like
related illnesses.
Statement of Purpose
The researchers conducting this study were interested in measuring the occurrence of influenza-
like illness in nursing homes in Belgium during the 2009-2010 seasons of influenza and
comparing individuals who had participated in a vaccination for A (HINI) 2009 and seasonal flu
against absenteeism for influenza-like illnesses among health care workers in nursing homes
during the same observation period.
Research Questions

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Does vaccination reduce risk of contacting influenza –like illnesses during an influenza
epidemic? Does vaccination for health care workers working in nursing homes reduce mortality
and morbidity among residents?
Study Methods
A quasi experimental design was applied in carrying out. All Belgian nursing homes (n=1,606)
were invited by the scientific institute of public health to voluntarily participate in a national
network for the surveillance of all new cases of influenza-like illness. A contact person was
placed at each facility involved for the surveillance and he/she provided details about the nursing
home i.e. total number of staff members employed and bed capacity. Staff members were
divided into 4 categories: paramedical, administrative, logistic and nursing staff. Influenza-like
cases were defined and the different variables to be investigated were also defined.
Data was collected through an electronic paper form questionnaire which was read optically for a
period of 5 months and the participants recorded observations twice a month hence providing 10
observations for each participant. STATA version 9 was used to process the data and the
indicators calculated were; the total number of new influenza-like illnesses per 1000 resident day
for the observation duration, proportion of staff members who were absent for influenza-like
illnesses program and the proportion of staff members who were vaccinated against A (H1N1)
2009 and seasonal flu.

Key Findings
The findings include; 25 nursing homes provided surveillance data and it was found out that a
total of 47 residents developed influenza like illness during the surveillance period. In addition,
the mean proportion of staff members who were not present for influenza like illness vaccination

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over the 5 months of surveillance were not significantly different between the professional
categories

Citation
Jans, B., Latour, K., Broex., E & Catry, B. (2010). Surveillance of influenza-like illness in
Belgian nursing homes. Archives of Public Health, 68, 100-108. Retrieved February 5, 2015.

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The summary template of the quantitative research review includes the following sections;

Title
Pre-exposure Prophylaxis in substance abuse treatment. This article was published in the
Substance Abuse Treatment, Prevention, and Policy journal in 2015 from page 1 to 15. The article
was authored by Anya Spector, Robert Remien and Susan Tross. This is a summary of a
qualitative study conducted to get the views of substance abuse treatment providers using the
grounded theory approach.

Problem Statement
The researchers stated that “In the US, there are approximately two million substance users in
community treatment programs who are at risk for HIV because of injection drug use and/or
unprotected sex under the influence of drugs and/or unprotected sex under the influence of drugs
and/or alcohol, substance users, and their sexual partners, are vulnerable to acquiring HIV”.
According to studies, New York city substance users have the same prevalence for HIV
irrespective of whether they use injecting needles or not hence the need for an introduction of
Pre-exposure Prophylaxis in substance abuse treatment.
Statement of Purpose
Since users and non users of needles in substance abuse have the same prevalence for HIV, it is
important to seek for views of substance treatment providers when they put clients in pre-
exposure prophylaxis care and research trials.

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Research questions
What is the feasibility, impact and the acceptability of pre exposure prophylaxis on substance
treatment providers’ practices in substance abuse treatment programs in the community?

Study Methods
A non experimental design was used to conduct the study where 36 medical and counseling
practitioners in from 6 New York outpatient substance abuse treatment programs were invited to
participate in qualitative semi structured interviews. 3 coders prepared a code book for
performing content analysis on the data using Research Ware Hyper Research qualitative data
management software.
Key Findings
After conducting the research, it was evident that pre exposure prophylaxis from the providers’
view was defined by 6 themes namely; it was not fully determined if clients would adhere to
medication, people were not fully aware about pre exposure prophylaxis, PrEp ambivalence,
there was a perception of several challenges to delivery, emerging concerns about side effects
and safety, possible barriers in conducting clinical trials.

Citation
Spector, A., Remien, R., & Tross, S. (2015). PrEP in substance abuse treatment: A qualitative
study of treatment provider perspectives. Substance Abuse Treatment, Prevention, and
Policy, 10(1), 1-10. Retrieved February 5, 2015.

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Part 3 (Critique of Research Studies)
Quantitative research article critique

Title: Surveillance of influenza-like illness in Belgian nursing homes
Abstract: The study did not provide an abstract and the researcher went straight into the
introduction and started stating the variables for the study.
Statement of the problem: The researcher does not clearly state the problem for the study.
Instead, a brief description is stated in the introduction section of the study.
Hypothesis/research questions: The researcher does neither states the hypothesis nor the
research questions for the study since after writing the introduction section, he/she proceeds to
the methodology section.
Literature review: The researcher does not review any literature on this study topic since after
introducing the topic, he/she proceeds directly to the methodology.
Conceptual/theoretical framework: The researcher does not state any theory to be proven in
the research study.

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Qualitative research article critique

Topic: Pre-exposure Prophylaxis in substance abuse treatment: a qualitative study of treatment
provider perspectives.
Abstract: The researcher stated the abstract at the beginning of the paper hence providing an
insight about the contents of the study. In the abstract, the following contents were included;
objectives, method, results, conclusion and keywords of the study.
Introduction: The researcher gives a lengthy introductory part without separating the various
sections of chapter one.
Statement of the problem: The researcher does not provide a clear statement of the problem
under study. Instead, the problem is partially described in the introduction part.
Research questions: The research questions being studied in the research are not clearly stated
in their own segment though they are included in the introduction section.
Literature review: The researcher reviews previous studies in the on this topic and hence
establishes the need for further studies. The literature review is not mentioned on its own section
and instead, only a small section of the introduction tackles it.
Conceptual underpinnings: The researcher develops the grounded theory in this study by
collecting data and analyzing it to show themes in the population under study.

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Part 4 (Critique of Research Studies)
Quantitative research article critique (Method)

Protection of human rights: Human rights were protected since each participating nursing
home was allotted with a unique study number. The contact person collecting the data also
allotted a unique resident study number to each and every influenza-like illness case hence
ensuring confidentiality.

Research design: The researcher conducts a quasi experimental where selection of samples was
not randomized. Since the researchers were mainly interested in the correlation between groups
of professionals which undertook vaccination and the other group which did not vaccinate, then a
correlation approach would be the most appropriate.
Population and sample: The researcher invited all health care workers in all nursing homes to
voluntarily participate in the study. To achieve randomization in determining a sample size, the
researcher should have used a probability method to determine the sample for the study.
Data collection and measurement: Data was collected by questionnaires which were
electronically transmitted to the science institute of public health. Due to the many observations
which required to be observed, a questionnaire was the best tool used to provide the required
structure of presenting the data which was processed through STATA version 9.

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Procedures: The sampling procedure required that participants record observations twice a
month for the duration of 5 months. The participants were only tested for influenza-like illnesses
without testing the presence of influenza virus. This made it difficult to differentiate between
influenza-like illness and seasonal flu.

Qualitative research article critique (Method)

Protection of participants’ rights: The researcher states that no names were recorded for the
individuals participating in the study hence ensuring confidentiality.
Research design and research tradition: The researcher opted for a non experimental design to
conduct his study. It is justifiable since it was a qualitative study aimed at obtaining practitioners
views.
Sampling and setting: The researcher purposefully selected all available participants to
participate in the survey since this is a non probability study.
Data collection: Data was collected through semi structured interviews in order to obtain the
views and opinions of the participants sampled. This was the best method to be used since it
would allow subsequent content analysis.
Procedures: The researcher used the community based participatory research approach. This
approach used was satisfactory since it has shown to enhance validity and relevance of research
findings in the last 20 years.

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Enhancement of trustworthiness: or the validity of the data and confidentiality of the study
data, the institutional review board approved the necessary procedures for undertaking the study.

Part 5 (Critique of Research Studies)
Quantitative research article critique

Results:
Data analysis: Data was analyzed using STATA version 9 and the output was presented in
graphs and tables. The epidemic curve was not the most appropriate output since the researchers
were interested in the correlation of the data.
Findings: It was evident that nurses in nursing homes with less influenza-like illnesses were
frequently vaccinated compared to nurses in nursing homes with most influenza-like illnesses.
The researcher remained in the context of the research objective.
Reliability and Validity: The data collected was scarce and rarely met the threshold for
statistical tests. The comparative analysis of the vaccination experiment was not statistically
significant at 95% confidence interval due to small numbers of participants in some categories.
Discussion:
Interpretation of findings: The researcher states that continuous influenza-like illness
surveillance is good since it provides data which could be used for ensuring that necessary
actions are adopted in these nursing homes to fight influenza-like illnesses.

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Implications/recommendations: The researcher gives a clear recommendation by stating that
the results obtained from this study could lead to a more rational management of influenza –like
illnesses in the nursing homes.

Global Issues
Presentation: The findings and discussion of the study were well presented and accessible to a
practicing nurse but the other parts of the study were not sufficiently organized.
Researcher credibility: Despite several weaknesses in the study, the researcher achieved
credibility through research triangulation during data collection and analysis.
Summary assessment: From the study findings, the researcher provides evidence that nursing
practitioners can gain important insights on the usefulness of the vaccination.

Research Design: The researcher employs a quasi-experimental research approach where the
sampling method used did not employ randomization of samples allocated in the study. This
research design involves collecting data to test an already stated hypothesis/ theoretical
framework. A true experimental design approach utilizes random sampling so as to obtain data
which is representative of the population and enable the researcher to be able to draw inferences
from the data regarding the whole population. The researcher does not achieve randomization
which is an important tool in conducting statistically significant tests. The researcher is interested
in demonstrating cause and effect assumption of the quasi-experimental design by vaccinating a
portion of the nursing health care workers in the nursing homes.

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The researcher invites all Belgium nursing homes to voluntarily participate in the national
surveillance of all new cases of influenza-like related cases. A quantitative research design
entails a research assistant who is not part of the survey. In the study, a local contact person is
incorporated at each nursing home so as to relay information such as the total bed capacity and
number of staff members employed to the scientific Institute of Public Health. Several variables
were included in the data collection questionnaire and the data was collected during the
surveillance period (1 November 2009 – 31 March 2010) i.e. twice per month providing 10
observations for each participant sampled. Data collected is analyzed using STATA version 9
and analysis is conducted so as to perform statistical tests which are vital in testing the
significance of the hypothesis. The findings and the discussion have been presented to describe
the phenomenon under study.

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Qualitative research article critique

Results:
Data analysis: Content analysis was performed to identify themes which were being studied.
Developing a wider content code book would have avoided saturation of data at the 12 th
interview.
Findings: The providers gave their views and the researcher was able to document the lengthy
findings hence providing more insight about PrEp in substance abuse treatment.
Theoretical integrations: Ground theory was developed effectively in the study from sampling,
data collection, and analysis to findings.

Discussion:
Interpretation of findings: The researcher gives a very lengthy discussion. From the study only
a small proportion of the providers had knowledge about pre exposure prophylaxis before the
interview. This weakened the study topic since only 10% of the data collected was relevant. It
was however recommended that more awareness to be created to the providers and clients.
Implications/recommendations: The researcher recommends that more awareness on Pre-
exposure Prophylaxis in substance abuse treatment needed to be created to the providers and
clients.

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Global Issues:
Presentation: The researcher provided a well organized and sufficiently detailed report for
critical analysis.
Researcher credibility: The researchers’ choice of semi structured interviews, 3 coders for
conducting the content analysis and comparative analysis of the data enhances confidence in the
findings and their interpretation.
Summary assessment: Despite the low practitioner awareness of PrEp, the researcher provides
valid findings on this study which could be used as empirical evidence during further studies or
the nursing practice.
Research design: The researcher develops the grounded theory in the entire qualitative study.
The major strength associated with this theory is that the data collected assists in forming and
developing a theory as opposed to other study methods with already predetermined theories and
hypothesis to be followed in the entire study. Developing an emerging theory as described in the
study reduces the researcher’s bias and is less likely to influence the outcome of the study which
is contrary to other qualitative research approaches such as ethnography where the group/issue
under study is described prior to data collection (Silverman, 2000). During the sampling process,
the researcher picks different categories of participants to participate in the survey purposively.
The researcher designs semi structured qualitative interview procedures using a community
based participatory research approach so as to enhance the external research validity and the
relevance of the finding which is important in developing this theory. In the participant

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recruitment, 6 providers i.e. one clinic director, one medical provider and 4 counselors from each
of the 6 agencies in New York were invited for the interviews (n = 36). For comparative
analysis, the researcher picks an experienced provider of both substance abuse and HIV services
and 2 community based collaborators; one with experience in substance abuse treatment and one
with expertise on HIV prevention. The researcher conducts the interviews until saturation is
reached where valid and reliable data is gathered for analysis. 3 coders were incorporated to
analyze content in the data using Hyper Research qualitative data management software.

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Bibliography
Jans, B., Latour, K., Broex., E & Catry, B. (2010). Surveillance of influenza-like illness in
Belgian nursing homes. Archives of Public Health, 68, 100-108. Retrieved February 5,
2015.

Polit, D. F., & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for
nursing practice (9th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. ISBN-13:
9781605477084 (Available as print text only.)

Spector, A., Remien, R., & Tross, S. (2015). PrEP in substance abuse treatment: A qualitative
study of treatment provider perspectives.Substance Abuse Treatment, Prevention, and
Policy, 10(1), 1-10. Retrieved February 5, 2015.
Silverman D. Doing qualitative research. London: Sage Publications, 2000

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