Critique of Quantitative Article
NURS 3270: Nursing Research and Evidence-Based Practice
December 07, 2010
Article.Critique of Quantitative Article
Chiang, C. Y., & Sun, F. K. (2009). The effects of a walking program on older Chinese American immigrants with hypertension: A pretest and posttest quasi-experimental design. Public Health Nursing, 26(3), 240-248.
Background and significance
Hypertension has many negative impacts on health; hypertension among Chinese American immigrants has not been widely studied. Sedentary behavior is one of the major risk factors for both stroke and hypertension. The significance of identifying culturally specific ...view middle of the document...
It is reported that Chinese Americans are identified to have high rates of hypertension. There is a need for further study in this area. The same variables were measured prior to the 8-week walking program for both groups. Increasing nurses’ awareness of the need to be culturally sensitive may result in greater participation and more sucessful outcomes.
Review of literature
Research includes a well-documented reference list. A stages of change questionnaire was used. Other similar studies are discussed in regards to stratigies to increase walking behavior. The stages of change model and Lenninger’s Culture care theory were used. Primary at the end of the program, SOC questionnaires were administered and blood pressure was checked again. Information about the duration, intensity, and frequency of exercise was gathered each week from subjects. Research according to the reference list>20 articles were reviewed.
Review of research indicates little study was found on exercise programs for older Chinese American immigrants. Limitations discussed include selection method and the quasi-experimental design. The literature review flows logically allowing understanding of how researchers formulated the research question. Multiple studies designs and strategies to increase walking behaviors were examined.
Internal and External Validity
Internal and external validity measures include pretest demographic measures of blood pressure, physical activity, SOC or stage of readiness. Each of the two groups received the 8-week walking program based on Jitramontree’s Protocol-Appropriate controls. The quasi-experimental design limits the ability to generalize this study’s findings.The inclusion criteria was sufficient to avoid bias. The participants as well as a family member in the in the CMW group gave informed concent. There was no discussion about how the data or identities were protected, or how the researchers and translators who made the phone contact were chosen or trained. Sources of bias include how active the participants were pre-study. Cultural modification was an intentional part of the study therefore; culture should not be considered a bias. Threats to internal validity include differing levels of education as those with more education had tendencies to walk less and those with lower levels of education walked more minutes per week. Previous walking habits should be considered, as the Chinese are known to have a long history of walking. People of the Chinese culture respect authority figures; therefore, participants involved in collecting the data could have represented authority. Fidelity was maintained with inclusion criteria, recruitment, and approval of the Institutional Review board. Based on the application Leininger’s Culture Care Theory (Leininger & McFarland, 2002) Chinese cultural aspects were added to the walking intervention for each stage of change.Thus, the intervention design was culturally sensitive.