Table of Contents
The specific research problem investigated by Brüggemann & Swahnberg (2013) is abuse in healthcare settings in Sweden. Patients might experience suffering in healthcare settings that is unrelated to their illness and even in cases wherein they receive clinically correct treatment. Such encounters do not result in short- and long-term suffering but have a considerable impact on the level of confidence that patients have in the healthcare system (Brüggemann & Swahnberg, 2013). Essentially, unpleasant healthcare encounters can have far-reaching consequences for the patient. Harmful encounters or experiences in the healthcare settings have been described as abuse. In particular, the prevalence of abuse in healthcare settings is 20 percent for female patients and 8 percent for male patients. Patients often suffer when they experience abuse in healthcare settings. However, there is little understanding of the factors that contribute to the abuse of patients in healthcare settings (Brüggemann & Swahnberg, 2013). Understanding the factors that contribute to abuse in healthcare settings can help healthcare professionals to be aware of how their actions and behavior cause patient suffering. It is an important step in reducing the prevalence of abuse in healthcare settings. Thus, the problem statement that triggered the research is a timely and important issue in healthcare that requires urgent solution in order to enhance the quality of care provided to patients.
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Brüggemann & Swahnberg (2013) established the significance of their research by highlighting the prevalence of the problem, namely the abuse of patients in healthcare settings. In addition, the significance of research was emphasized by highlighting the consequences of patient abuse, which included short- and long-term suffering. Moreover, patient abuse has negative consequences for the whole healthcare system, since patients start losing confidence in it. Despite the high prevalence of patient abuse and the resulting negative consequences, there has been little research interest aimed at understanding the factors that contribute to abuse in healthcare settings, especially from the perspective of patients. Thus, this study is of significance to healthcare professionals.
Purpose and Research Questions
Brüggemann & Swahnberg (2013) clearly stated the purpose of their study, which was to understand the factors that contribute experiences of abuse among female patients in healthcare settings. The researchers maintained that gaining further insights regarding the manifestation and deterrence of patient abuse in healthcare settings, it is crucial to interview patients. Thus, in their study, they asked patients about experiences they considered abusive in healthcare settings. It is contrasted with past studies that focus on exploring the meanings of abuse in healthcare settings.
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Brüggemann & Swahnberg (2013) did not clearly state the research questions that guided their investigation. However, it can be inferred from the findings that the research question that guided the research was “What contributes to abuse in health care?”
It is evident that this research question and the study purpose are related to the problem. In essence, the research problem relates to the increasing incidence of patient abuse in healthcare settings; thus, the study purpose and the research question are geared towards understanding the factors that precede the abuse of patients. It can be argued that the research question and study purpose are aligned to the research problem.
The qualitative method used to answer this research question was the constructivist grounded theory using in-depth interviews. Grounded theory helps to develop theory and explain a phenomenon. Since the research focused on understanding the factors that contribute to abuse rather than explaining the experiences of abuse, the grounded theory approach was the best suited. According to Burns & Grove (2011), research question in grounded theory is geared towards identifying rather than making assumptions regarding the phenomenon being investigated. In addition, grounded theory requires the use of open-ended research questions that do not simply require yes/no responses. Therefore, an inference is that the grounded theory approach adopted by Brüggemann & Swahnberg (2013) was appropriate for their research questions.
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Brüggemann & Swahnberg (2013) cited qualitative and quantitative studies that are relevant to the focus of their research. For instance, they mentioned qualitative studies conducted by Swahnberg et al. (2007) and Swahnberg et al. (2009) that focused on exploring the experiences related to abuse among female patients in healthcare settings. The literature review also cited a number of quantitative studies that operationalized the abuse of patients in healthcare in order to study the prevalence of patient abuse. However, the weakness of this literature review is that it is not comprehensive in the sense that it only cited four research studies. A comprehensive literature review could have helped Brüggemann & Swahnberg (2013) position their research in the existing scholarship and enable them to make a strong argument for the lack of research interest in explaining the factors that contribute to the abuse of patients in healthcare settings. Moreover, the authors did not include other types of literature such as meta-analysis and seminal works related to the phenomenon under study.
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The references used in the literature review are current. It is because the quantitative studies cited fall within the five-year limit. For the qualitative studies, one study cited was six years old; however, this is allowable since older qualitative studies might be of relevance to a qualitative research.
Brüggemann & Swahnberg (2013) did not evaluate the weakness of existing studies. The literature review focuses on the findings of existing studies rather than assessing their methodological rigor, especially for the qualitative studies. In addition, for the quantitative studies, Brüggemann & Swahnberg (2013) only described the operationalization of the patient abuse and then presented the findings. No effort was made to evaluate the weakness of these studies.
The information presented in the literature review is not sufficient to develop a logical argument. The literature review focuses on two aspects, which include describing the experiences associated with patient abuse in healthcare settings and the prevalence of patient abuse. It is inadequate to develop a logical argument or narrative that can form the basis of the research. Reviewing additional studies on the issue could help the authors to devise a more string argument and make a case for their research.
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Brüggemann & Swahnberg (2013) clearly identified a specific perspective from which they developed their research. In this respect, they developed a theoretical framework that could help understand the occurrence of patient abuse irrespective of healthcare practitioners trying to offer the best possible care. To this end, the authors used the Galtung’s theory of violence that differentiates cultural violence, structural violence, and direct violence. The theoretical framework also contained components derived from the Glover’s theory of moral identity, which was used in explaining the existence of violence in a system designed to assist patients. Brüggemann & Swahnberg (2013) also developed a framework as part of their findings, which is presented as a diagram. Their findings indicated four categories including structural limitations, domination techniques by staff, the competence of the patient, and the vulnerability of the patient. The framework developed based on these findings captured the relationships between these themes, with the ultimate outcome being the patient losing the power struggle (Brüggemann & Swahnberg, 2013).
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