Assessment � Critical Appraisal Assignment Sample

Part 1. Introduction or background

The concept of critical appraisal refers to the use of a systematic process that helps in identifying the strengths and limitations of a research article with the aim of assessing its usefulness and validity in the research field (Gall and Pigni, 2022). The given article is based on the work stress present in NHS employees and its impact on patient care. The NHS or national health services in the UK is considered a publicly funded healthcare system and the second largest healthcare related system in the country (Tennison et al. 2021). This organisation is also the single largest recruiter in the UK with the present 1.5 million employees and the management of funds maintained through the use of public funded taxes (Ravalier et al. 2020). In terms of addressing the result of NHS annual survey 2022, it was revealed that 44.8% of healthcare staff under the organisation have reported to feel unwell due to excessive work-related stress (Nhsstaffsurveys, 2023). This is followed by presenting a high date of sickness absence among employees in terms of facing stress anxiety and other mental health illnesses. The identified organisation also has been targeted as having higher than average stress sickness absence among employees in comparison to other job sectors in the same country (Ravalier et al. 2020).

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On the other hand, the presence of high job stress impacts employees' performance which leads to more error, poor work capabilities, high mental health issues, burnout and conflict in the working environment (Obrenovic et al. 2020). This is followed by a high rate of employee turnover and employee engagement and absenteeism which can impact both the organisation and personal relationship of the employees. That chosen article has successfully addressed these issues by highlighting 15.4 million working days for the employees which were lost due to the presence of excessive box stress, depression and anxiety in 2017-2018 (Theguardian, 2021). This is followed by losing walking days of 57% due to the presence of sickness absenteeism among employees alongside mental health issues in the UK (Theguardian, 2021). These all issues in the images have a high impact on health and patient care by impacting the employee's psychological and physiological health. However, the identified research paper also focused on the general association of the organisation in terms of providing a better-quality care system by the employee to deal with their patients while focusing on the patient facing roles and improving communication between the employees and patients to achieve a positive outcome.

Part 2. Ethics and sampling

In the case of the research process obtaining ethical approval is considered as a significant step for the researcher to demonstrate the adherence of accepted ethical standards to produce a genuine research study (Ravalier et al. 2020). This refers to the presence of a set of principles that helps researchers to design for practice alongside the inclusion of voluntary participation, information consent, anonymity confidential and potential for harm and result communication for the research participation (Salama et al. 2022). Apart from that, the heading ethical norm in the case of research is considered a significant step that promotes the aim of research alongside knowledge truth and avoidance of error. These also include prohibition against data fabricating information and miss presentation of research information to promote truth while minimising the overall research error (Pandey and Pandey, 2021). While ethical committees are present in terms of reviving the overall proposal, they are also involved with human participation and insurance in the inclusion of information in regards to the local and national ethical guidelines. The primary responsibility of the ethical aspect and managing ethical consideration in the research process refers to the reduction of possible risk to the community and environment while committees’ author the approval rejection and modifications and declining studies without meeting ethical standards (Platts et al. 2022).

The following context which is based on the identification of excessive work-related stress among in inches employees in the UK both qualitative and quantitative methods are used while conducting studies. While qualitative survey was collected by employing web-based information collection software Qualtrics, it refers to the sending mail containing surveillant for all the staff involved in the research process (Ravalier et al. 2020). The data were collected after one week following and before the online survey process and information consent from were sent to maintain ethical aspects of the involved persons. The ethical norm regarding quantitative survey method referred to the issues of recording honesty while answering survey questions alongside meeting the requirement for informed consent paper and maintaining anonymisation of identities of survey participants and storage of collected information (Ravalier et al. 2020). On the other hand, ethical risks including responding to survey questions without understanding the risk and voluntarily consent for participation are considered another significant risk while conducting the research process that can impact the ethical standard of the research (Morley et al. 2020). This is followed by conducting a qualitative semi structured interview via another all-staff email which was designed by the research team and Saint to the team management of the identified organisation. First come first basis interview was conducted with the aim of collecting information on the employee stress level and its impact on the patient care in the NHS and collecting saturated thoughts of employees at an iterative round of the interview process (Ravalier et al. 2020). A consent form and an information sheet were sent to the participant before 48 hours of the interview process and those were accepted via an email. The collected information was kept separately to maintain anonymity. Each interview was initiated with a reminder of ethical considerations and verbal consent from the participants and lasted for 45 minutes. As the interview was conducted via telephone, was audio recorded and professionally transcript prior the analysis of information, completely different researchers were present for separating data and participation to avoid breaching ethical issues (Ravalier et al. 2020). Ethical approval was received from the University of Bath Spa research ethics committee. The sample size is 1644 in response for a survey alongside 33 individuals for the completion of a semi-structured interview process. While the interview process was done by using non-probability sampling technique, the survey process was done by using probability sampling.

Part 3. Data Collection

The significance of using research methodology refers to the providence of a legitimate research scientifically sound findings with a detailed plan to keep the researcher on crack while making the process easy, effective and manageable (Heap and Waters, 2019). This also includes the validity of research information alongside ethical consideration and the well ability of the work progress to achieve a desert outcome by using the framework of method for designing, conducting and analysing the overall steps. For the given research paper, a mixed method study has been used to identify the impact of stress on NHS employees alongside the strategies to improve the staff experience in patient care (Califf et al. 2020). The method study includes an employee survey and an individual semi structured interview process to investigate the influence of working conditions in the images alongside the impact of stress on employees while taking care of patients (Ravalier et al. 2020). This factor consists of using quantitative survey method alongside quality semi structured interview method with the aim of managing an in depth explanatory and confirmatory research process in the field of health and social care research.

Collection of information was done by two specific methods including quantitative survey in the form of using web-based data collection software called Qualtrics and quantitative method by conducting individual semi structured interviews of NHS staff (Ravalier et al. 2020). The first method of data collection refers to putting together an email which consists of the surveillance regarding research questions and was sent for all the staff including clinical and non-clinical in the NHS. These emails were sent in February 2018, followed by sending reminders to the staff after 2 weeks to gather the respective information. The first page of the email refers to the consent form for the participants to avoid any ethical issues for the research process (Ravalier et al. 2020). Apart from that, for the semi structured interview process of data collection, the participants were invited by using all staff email which were designed by the research team and were the same to the senior management of the selected healthcare organisation. In this step, first come first based interviews were taken to complete the data collection process.

The use of mixed methods is considered a significant strength of the identified study and helps the researcher put together a large data set to compare the response of NHS employees to shade light on their working conditions in the UK (Ravalier et al. 2020). It also benefited the research team to gather detailed and contextualised insight of research information and improve the overall outcomes. This is followed by mitigating generalisation of research information and externally valid research data with the aim of understanding research problems and yielding the complete evidence on the research subject (Nadarzynski et al. 2019). However, while addressing limitations of using a mixed methods in case of research subject the overall process is considered a complex step to carry out and requires excessive individual expertise to manage the overall data collection and data analysis process (Åkerblad et al. 2021). In addition, it includes interpreting results from using those two methods while combining the available information by using extra resources in the form of time and cost.

Part 4. Data analysis

After the collection of significant information, the information is analysed by two methods. In case of quantitative information that collected information or analysed by using IBM SPSS 24.0. The use of descriptive statistics was presented with the aim of identifying mean median and standard deviation alongside identification of frequency from the collector information (Krachler et al. 2019). The specific software in the data analysis process is used to prepare and analyse the information by using an intuitive interface while writing codes in an easy way. This is followed by the integration of collected information with an open source to enhance the information quality and using this advanced statistic-based tool to develop tabulated reports on the research subject (Pallant, 2020). This has been used by the researcher in the following case study to compare the UK benchmark alongside adding regression analysis with the aim of investigating the influence of walking specific conditions on stress and psychological wellbeing of the identified population. On the other hand, collected qualitative information was analysed by using thematic analysis and the steps were followed by using Braun and Clark steps (Braun et al. 2021). The primary objective of using thematic analysis in research referred to the identification of themes in the form of patterns in the information and use those themes to address the identified research problem (Ravalier et al. 2020). This process of data analysis is considered an accessible form of analysis and improves the chances of achieving desired outcome at the end of research. In addition, this process of data analysis also helps researchers to identify the salient significance in the collected material and understand the underline aspect of phenomena of the research subject (Campbell et al. 2021). This has been used in the following context in the form of repeated listening to the recording using N-Vivo software for the transcription of information into themes and subthemes (Ravalier et al. 2020). Three major themes were created from the collected information which were further splatted into sub themes and were used as independently code to reach a conclusion of thematic analysis.

The primary aspect of reliability and validity are considered significant for researchers to assert the rigour of quality process while understanding the reliability of used concepts alongside the validity which are effective to maintain the research quality (CohenMiller et al. 2022). For the following context, while using qualitative and quantitative methods, the relationship with line manager colleagues and supervisor was maintained properly within the work and support were provided for the teamwork and positive relationship was maintained throughout the study process. These were considered the source of encouragement alongside the maintenance of effective communication to achieve the desired outcome (Amin et al. 2020). Therefore, the advantage of this process refers to an effective communication process among researchers while managing the work, the negative aspect refers to disagreements and dissonance.

Part 5. Findings

With a response rate of 14.5% the selected employees were able to answer in the case of invited emails. As the research context contains demographic questions, forced responses were received without missing any information. This is followed by identification of results in the form of answers by majority of participants to identify the excessive working hours which refers to the 3.7 to 7.2 hours excess per week (Nhsstaffsurveys, 2023). However, in the UK the average working hours per week refers to 48 hours on average and the responsible legal aspect is considered the working time directive and working time regulation to dictate the legal working hours for individuals (Gov.uk, 202). While keeping the management sample for the following study the result expressed the presence of higher stress in the form of one standard deviation and this explains the presence of high walk load for all employees respective of their job rules in the UK. This also explains the lower average psychological wellbeing of the employees alongside and satisfied job rules and absenteeism up to 42.1% in the last 12 months (Gov.uk, 2023).

On the other hand, the study successfully demonstrated the significant three factors such as wellbeing at the working environment and work relationship and communication between employees are significant factors that have the overall impact on the employee retention and their performance on the healthcare setting. Employees' wellbeing includes a greater level of energy and high input and lower rate of absenteeism (Ravalier et al. 2020). However, the presence of factors such as stress, anxiety and work pressure impact employee wellbeing and their overall performance at the working environment. For the case of NHS employees, lack of support and high workload and continuous changes in patient care setting has impacted their capabilities of working stress free and then being productive (Theguardian, 2021). It also impacted their psychological well-being by induced high work stress, anxiety and chances of depression. However, the relationship between the psychological wellbeing of staff and its impact on the different levels of healthcare employees were not specified and it required further research. In addition, workload of employees was also addressed which was excess for the weekly average in case of NHS employees (Ravalier et al. 2020) while dealing with patients and a significant reason for decreasing psychological well-being. This is followed by relationships among employees within the work to influence their overall wellbeing and performance capabilities.

Most of the articles that have been used for the identified studies are based on the images factor which are associated with employee performance barriers to improve workplace health and well-being alongside staff health and well-being and staff stress level which have significant impact on increasing stress level among images employees. As the research study title is based on the stress level of NHS employees and its impact, the implied resources are considered effective to provide a greater insight on the research context.

Part 6. Application to Practice

Healthcare sector is considered in place for numerous psychological and emergency responses by the employees including shift work managing emergencies and high emotional loads while dealing with patient centred care (Søvold et al. 2021). Therefore, while the identified research context is predominantly describing the stress level among NHS workers alongside its impact on their psychological well-being, it was found that contribution towards wellbeing and perceived stress score of impact on employee stress does impact the overall performance while managing patient care, meeting patient demand and controlling the overall emergency situation. This also impacted on reducing the overall healthcare demand alongside increasing the level of control of the health care staff roll in the same organisational setting. The improvement of stress level of employees can impact productivity by managing heavy work alongside comfortable shifting and adequate process to maintain patient centred care by the healthcare professionals while reducing the employee turnover and absenteeism (Lateef, 2020). This is followed by using significant recess for employees in the form of changing communication using consultation over change alongside the providence of significant opportunities to input and timely inform the upcoming changes which affect the employee’s performance in a positive way. These are considered significant findings from the following research study which have potential impact on identifying the difference between management and employees in the working environment and investigating the changes and their impacts in more depth (Bevan et al. 2022). This could also be used to increase physical activity and job satisfaction of employees alongside reducing sickness absenteeism among them.

While addressing the example of clinical practices in terms of demonstrating the research findings the use of educational training intervention in terms of managing clinical practices and dealing with psychological wellbeing of employees at the hospital setting. The use of educational training of healthcare employees is considered a significant step that helps in preventing stress and burnout among healthcare teams and improving the person-centred care process by maintaining psychological wellbeing of staff (Fisher et al. 2021). This factor helps employees and the authority with the encouragement of connection with the team alongside developing behaviour to control the intensity of stress (Fisher et al. 2021). However, it requires the use of multidisciplinary team performance and investment of hospital resources while implying this context.

Part 7. Conclusion

In terms of concluding the overall context NHS employees are facing issues while managing patients centred care and maintaining their psychological building. This is followed by identifying ethical considerations that are maintained in the following contains to limit the reaching of ethical norms and managing data collection and data analysis process. The given study context has used a mixed method of research process in the form of qualitative semi constructed interview and quantitative survey methods alongside ensuring a thoughtful diligence research while maintaining honest communication between the researcher and audience to achieve the desired outcome.

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