Abstract
This paper is a literal critique of Wang et al.’s study that was conducted between 2021 and 2022 and published in 2023. The study investigates how mobile-based application programs such as WeChat are crucial in rehabilitating patients who have undergone knee or hip arthroplasty. Generally, the authors have used all the scientific procedures of conducting research, only that at some point, they tend to use some outdated references as their primary sources. They also take long intervals to measure the outcomes, which might affect the consistency of the results. In addition, the study combines total knee and hip arthroplasty, making it even more complicated and unable to yield harmonious results. In general, the research lays a fundamental foundation for being used in practice as well as paving the way for further research.
Introduction
As an academician, it is necessary to analyze other people’s work, acknowledge their excellence, note their weaknesses and limitations, and suggest some of the issues they might have included in their research. This is done through a literature review where every part is reviewed and discussed per these parameters(DeCarlo, 2019). This paper seeks to provide a critique of Wang et al.’s (2023) study, with the motive of reviewing every part of their study and providing feedback.
Title Part
The paper’s title highlights the research design used, a randomized controlled trial. As the title suggests, the purpose is also communicated to measure the effectiveness of a mobile application-based program for rehabilitation after total hip or knee arthroplasty. However, the title does not communicate effectively on the population that the study was conducted on. It would have been more effective to include a part such as “A case study of discharged total hip and knee arthroplasty patients.” The authors are also listed after the title with their various designations noted, which is essential to make the readers realize that they are indeed familiar with the medical discipline in play, making it a credible primary source (DeCarlo, 2019).
Abstract
The abstract used for this paper was an informative type, with various subheadings being utilized to describe different parts of the paper (UNC, 2021). It includes a background part that explains how the illnesses in question are related to mobile-based application programs, the objective of the study, the study setting, the method used, including the participants (43), results realized after the 6-week study, and trial registration details. The abstract is very essential as it summarizes what the paper contains (UNC, 2021). The structure used was very informative and served this purpose effectively. It also compliments the information included in the title as it gives a deeper insight into what is included in the paper, filling in gaps realized in the title part, such as the participants in the study.
What Is Already Known Vs. What the Study Adds Part
Just before the introduction, the authors present the information that is already known and then identify the gaps that their study is meant to close. These parts are arranged neatly by utilizing bullets, which makes it easy to understand. In contemporary literature, studies are meant to close a gap in research or to confirm a certain phenomenon, making this a very important section of the study. It also provides a list to cross-check at the end whether the study has contributed towards closing the gaps that the authors have listed. According to Wang et al. (2023), their study adds to the literature that the collaboration of patients, their families, nurses, and health professionals is able to contribute to the development, implementation, and evaluation of a feasible mobile app that can help deal with the illnesses in question. They also seek to add the literature that the use of mobile applications is an effective way of improving quality of life and reducing instances of anxiety and depression from 6 to 10 weeks after being discharged for either total knee or hip arthroplasty.
Introduction
Wang et al. (2023) introduce the paper with various factors about hip or knee arthroplasty, such as commonly performed surgeries worldwide and the frequency at which the patients are discharged (1 to 3 days). This introduction forms a base to bring about the criticality of involving telehealth in the rehabilitation of such patients, which introduces the concept of mobile-based applications, which is the central concept of the study. However, I feel that there is a need to give a more detailed description of these conditions so as to allow the reader to hold an in-depth understanding of the issue being discussed; with this information, they are able to relate to the topic even more and compare their views on issues such as the hypothesis. It is also notable that the authors state facts that are well-cited from peer-reviewed sources, making their statements academically right. However, the authors, in some instances, might have used outdated sources such as the citation “Rusell et al. 2011.” This is a source that is from more than ten years ago, which means that some of the findings may have changed or been updated over time. It is crucial to use credible information that is up-to-date whenever one is carrying out research. The study then discusses how the advancement of technology has become important in the health sector as it enhances more comprehensive service delivery, especially in telerehabilitation settings.
The authors notice the psychological effects of arthroplasty patients that come as a result of pain and loss of functionality, leading to moments of depression and anxiety, which calls for mobile application for a more focused rehabilitation either by the patients themselves or their caregivers through the various health personnel. This is a very important observation, as according to their literature review, it had not been extensively explored. The study also poses their hypothesis clearly, as they write that they look forward to results showing that those who received mobile-based application telerehabilitation would show improved quality of life, including reduced psychological issues, compared to the control group. A hypothesis is important in a study as it is used to test the results, ruling whether the authors foretold the correct observation or otherwise (Woo, 2019).
Methods Section Critique
This section has been neatly arranged into sections: the study design utilized, how the participants were recruited, randomization, blinding, the sample size used, interventions, How outcomes were measured, statistical analysis, and lastly, the ethical approval and study registration part. This provides a comprehensive overview of the method used to conduct the study, making the reader understand the study even more deeply. The research design used was randomized control trials (RCT). This research design has disadvantages in that there is a possibility that the experimental group may not compare well with the control; there are potential variables that may not be put into consideration when employing this research design, such as other underlying illnesses, the social status of the patients, among others (Saldanha et al., 2022). This means that the comparison of the end result may not fully reflect the phenomena being investigated. However, RCTs are widely used in measuring efficacy as they give comparative results that are easy to compare (Saldanha et al., 2022). The recruitment method used justifies that there was no predictability in selecting the participants, which is common in RCTs. The recruitment process used was also useful in that it provided an avenue to eliminate participants with existing conditions that would lead to inaccurate results when testing for efficacy.
Randomization is the central idea of RCT, and in this case, the researchers did a good job of eliminating bias in selecting the participants by using a non-member to do the randomization in the ratio of 1:1. In addition to this, the study used blinding, which further eliminated recruitment and selection bias, making the study even more transparent and professional. This has been excellently represented in a flowchart, confirming the credibility of the recruitment process for the participants in the study. The sample size used was 86 participants, with 43 in each group. The authors justified how they reached the number; they calculated the effect size ratio and the primary outcomes of the test. However, these calculations were based on estimations, meaning that the data could be entirely wrong whatsoever. The ones who received usual care were the control group, while the others who received telehealth care based on mobile applications such as WeChat were the experimental group. In all experiments, there is always a need to identify the control group, which is used to determine the change in the phenomenon being studied by comparing the data to that of the experimental group (Torday & Baluška, 2019). It is also important to make sure that the two groups undergo the same set of conditions that are set for each group. Wang et al. (2023) have done a great job listing down details of how the usual care program and the telerehabilitation programs were carried out on the two groups of participants.
The measurement of outcomes is a crucial part of research as it yields the results that are to be used to draw a conclusion (Creative Commons, 2020). In this case, the researchers did a good job in making sure that they measured the outcomes during the participant’s discharge from the hospital and two others 6 and 10 weeks later. However, these are long intervals of taking data from such a small sample size, and this is likely to bring about inconsistency in data as different living conditions of the participants may affect the outcomes. It is always important that researchers carry out statistical analysis of this caliber using trusted data analytic tools that are meant for research purposes, such as the one used in this case: IBM® SPSS Statistics version 27.0. This is an up-to-date version of the software and is among the world’s leading analytic tools used in solving data for both research and business purposes (IMB Support, n.d.). In addition to this, the software has a feature for effect size enhancements for various types of data, which is crucial in this case.
Results
This part should exclusively expand on the outcomes of the research, and according to this study, it aligns with this requirement (Creative Commons, 2020). Firstly, the authors specified the timeframe when the data was collected (May 2021 to February 2022), which confirms the 10 weeks that the data is said to have been collected in 3 intervals. In this section, the authors break down the participants into women and men, a part that I feel needed to be included when describing the study’s sample size. The part further analyzes the type of surgeries the participants had undergone, which is important to analyze at this point since there was blinding during the selection and grouping of the participants. The authors have also done good work by organizing the outcomes as primary outcomes, which were marked by an increase in self-efficacy of those who underwent mobile-assisted rehabilitation, secondary outcomes, which were marked by a decrease in depression, and anxiety index reduction of the same group and overall effects which were marked by the improvement of quality of life for the experimental group. However, the authors note that the decrease in depression and anxiety was not entirely tied to the experiment; this is a very crucial part of the research. Researchers should always note other factors that might have led to certain outcomes in their research in order to account for each outcome (Torday & Baluška, 2019). This proves that the researchers were keen and were not entirely focused on proving their hypothesis.
Discussion
This part translates the results into a more readable and academically approached review of the research. The authors analyze the various results, adequately explaining how they came to be and, in the end, come to the decision that their hypothesis was right; the experimental group achieved better self-efficacy, reduced depressive and anxiety behavior, and had a better quality of life as compared to the control group. However, pain relief was still an issue when analyzing the data. In the introduction part, the team hypothesized that pain associated with the conditions contributes to anxiety and depression among the patients, but in the end, they were unable to measure the outcomes of pain relief among the participants statistically, making it hard to draw this relationship.
Limitations Critique
The team did a great job analyzing the various limitations the study is tied to. In research, it is almost impossible to eliminate limitations as most of the issues covered are not all-inclusive; for instance, the sample size does not represent all patients with the two conditions, and neither does using one healthcare facility mean that it matches all others. These variables may bring about several limitations, which must be listed so that scholars do not wrongly interpret the findings by generalizing certain factors. There was a need for the researchers to narrow down to one type of arthroplasty rather than dealing with the two types, that is, total hip and knee arthroplasty, to reduce the study’s limitations. Investigating one phenomenon at a time is important in that it makes the results more uniform.
Implications for Research and Practice
Every research is meant to bridge a gap in both research and practice, making it a useful piece to practitioners and scholars. Indeed, this study is exceptional in both fields as it encourages practitioners to utilize telehealth interventions such as mobile-based applications to rehabilitate patients after surgery. Due to the various limitations that have been noted, as well as gaps in results, it also opens an avenue for scholars to research more on the topic. The authors have skillfully analyzed these factors and developed this section well.
Conclusion Critique
The authors present a very brief yet informative conclusion. They summarize the results that technological advances improve the self-efficacy of total hip and knee arthroplasty patients. It is also important that they provide an online link where the data can be assessed. This gives future researchers a starting point to carry out research that will address the missing information from this experiment.
Conclusion
Wang et al. (2023) conducted a well-detailed experiment on the use of mobile-based applications in improving the quality of life of total hip and knee arthroplasty. The study uses standard procedures in scholarly scientific research, synthesizing each section as required and landing on a feasible conclusion. However, there are some issues with using outdated references and choosing long intervals to measure the outcomes. In summary, the study is crucial in that it lays down a foundation for further research as well as being incorporated into practice.
References
Creative Commons. (2020). Starting where you already are. 2012 Book Archive. https://2012books.lardbucket.org/books/sociological-inquiry-principles-qualitative-and-quantitative-methods/s07-01-starting-where-you-already-are.html
DeCarlo. (2019, August 7). 2.2 sources of information – Scientific inquiry in social work. Pressbooks Create – Your partner in open publishing. https://pressbooks.pub/scientificinquiryinsocialwork/chapter/2-2-sources-of-information/
IMB Support. (n.d.). Downloading IBM SPSS statistics 27. IBM – United States. https://www.ibm.com/support/pages/downloading-ibm-spss-statistics-27
Saldanha, I. J., Skelly, A. C., Vander Ley, K., Wang, Z., Berliner, E., Bass, E. B., Devine, B., Hammarlund, N., Adam, G. P., Duan-Porter, D., Bañez, L. L., Jain, A., Norris, S. L., Wilt, T. J., Leas, B., Siddique, S. M., Fiordalisi, C. V., Patino-Sutton, C., & Viswanathan, M. (2022). Inclusion of Nonrandomized studies of interventions in systematic reviews of intervention effectiveness: An update. https://doi.org/10.23970/ahrqepcmethodsguidenrsi
Torday, J. S., & Baluška, F. (2019). Why control an experiment? EMBO reports, 20(10). https://doi.org/10.15252/embr.201949110
UNC. (2021, September 22). Abstracts – The writing center • University of North Carolina at Chapel Hill. The Writing Center • University of North Carolina at Chapel Hill. https://writingcenter.unc.edu/tips-and-tools/abstracts/
Wang, Q., Hunter, S., Lee, R. L., & Chan, S. W. (2023). The effectiveness of a mobile application-based programme for rehabilitation after total hip or knee arthroplasty: A randomised controlled trial. International Journal of Nursing Studies, 140, 104455. https://doi.org/10.1016/j.ijnurstu.2023.104455
Woo. (2019). Research Problems, Research Questions, and Hypotheses. Chapter 6, 96-110.
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