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Critical Review Form for Quantitative Studies Student Name: Laura Vogtle Date: 1/10/04 Citation: Kondo, T., Mann, W. C., Tomita, M., & Ottenbacher, K. (1997). The use of microwave ovens by elderly persons with disabilities. American Journal of Occupational Therapy, 51, 739 – 747. Comments STUDY PURPOSE: Outline the purpose of the study. How does the study Was the purpose stated apply to your research question? clearly? Yes X The purpose of this research to demonstrate the No impact of microwave oven use on the appliances used in cooking, meal preparation duration and kinds of foods prepared in elderly persons with disabilities. LITERATURE: Describe the justification of the need for this study. Was relevant background literature reviewed? Described restrictions caused by arthritis and Yes X visual impairments No Discussed impact of these restrictions on ability to cook Discussed popularity and use of microwave ovens, and their application as assistive technology. DESIGN: Describe the study design. Was the design appropriate for Randomized (RCT) the study question? (e.g., for knowledge level about this Cohort issue, outcomes, ethical issues, etc.) Single case design X Before and after This is a single subject study, withdrawal design, Case-control ABAB format. The design is appropriate because Cross-sectional there is no research about the use of these ovens in Case study elderly persons with a disability. Single subject design allows for an experimental approach to treatment in a pilot study format the will give information about the efficacy of the treatment. Specify any biases that may have been operating and the direction of their influence on the results. We don’t know who did the random phone call checks, which might have influenced the outcomes. The researchers were from a grant-funded program in assistive technology. The program may have used these subjects in previous studies. Comments SAMPLE: Sampling (who, characteristics, how many, how was N= 5 sampling done?) If more than one group, was there similarity between the groups? Was the sample described 5 subjects, 4 women and 1 man, all over age 60. in detail? Disabilities were arthritis; arthritis complicated by heart Yes X disease, asthma and residual from a stroke; impaired No mobility with pain, lower limb weakness, and fatigue; pigmentary retinitis; diabetic retinopathy and glaucoma, arthritic pain and heart disease. All were chosen from a pool at University of New York at Buffalo. No subjects had cognitive impairments. Was sample size justified? Describe ethics procedures. Was informed consent Yes obtained? NO N/A X Not mentioned OUTCOMES: Specify the frequency of outcomes measurement (i.e., pre, post, follow-up) Outcome measures data was recorded daily and collected weekly throughout all four phases of the study Were the outcome measures Standardized assessments were not used to reliable? measure outcomes. Yes X outcomes measured were; number of appliances No used in meal preparation, the number of different Not addressed foods prepared, and the length of time spent on cooking. These outcome data were measured by frequency counts on number of appliances and kinds of foods; duration of meal preparation was timed by the participants. All data was reported by Were the outcome measures participants and checked by random reliability valid? checks done by phone. Yes Reliability and validity: Reliability of participant reporting No was carried out by using phone calls to check on Not addressed X frequency of using cooking appliances, number of different foods prepared, and length of time needed for meal preparation. Correlation coefficients ranged from .88-.99 for frequency of use, .83 - .98 for different kinds of foods and .91 - .99 for length of time it took to cook a meal. INTERVENTION: Provide a short description of the intervention (focus, who Was intervention described delivered it, how often, setting). Could the intervention be Comments in detail? replicated in practice? Yes X No Subjects were given basic instruction in use, safety, food Not addressed preparation and appropriate containers prior to intervention. Intervention consisted of provision of a microwave oven. Data collection was via subject completed logs done on a daily basis. Data logged included number of appliances used in meal preparation, kinds of food prepared, and the duration of cooking time. The same data was collected across all 4 phases. The first A phase was for baseline data collection and the second A phase was withdrawal of the oven. The B phases were the times when the oven was placed in the home. Duration of each phase was 3 weeks. Logs were collected on a weekly basis. This intervention could have been easily carried out in a clinical setting except for the random reliability checks performed by phone call. Frequency of checks was not reported, nor do we know who carried out these checks. Was contamination Subjects were chosen from the same sample pool and avoided? there is a slim chance some of them may have known each Yes other and discussed the research. If any of the subjects No received therapy services at SUNY-B, they may have Not addressed X heard about the research from therapists working there. In N/A the process of receiving training in microwave use, it was possible subjects could have met each other or heard therapists discuss the study. Was cointervention Subjects may have participated in senior nutrition centers avoided? and received information on meal preparation there. Yes Family members may have known about the study and No encouraged/discouraged participants to use ovens. Three Not addressed X subjects had never used a microwave but two had. N/A Previous experiences may have affected their performance in the study. RESULTS: What were the results? Were they statistically significant Were results reported in (i.e., p <0.05)? If not statistically significant, was the terms of statistical study big enough to show an important difference if it significance? should occur? If there were multiple outcomes, was that Yes taken into account for the statistical analysis? No N/A X Data analysis was carried out by graphing the data, use of Not addressed descriptive statistics on each of the dependent variables, and inclusion of means on each variable graph across all Comments Were the analysis method(s) phases. appropriate? Yes X Study findings: Overall, the study demonstrated that No subjects needed less time to prepare a wider variety of Not addressed foods. Study results were affected by illness to some subjects and by life events. One subject who liked to cook increased the time she spent cooking due to experimentation with different foods. Subjects felt microwave ovens were safer than regular ovens. Shortening cooking times meant less time standing for those participants who had weakness and pain in the lower limbs. Was clinical importance What was the clinical importance of the results? Were reported? differences between groups clinically meaningful? (if Yes X applicable) No Not addressed The outcomes of the study were clinically meaningful. There was a marked difference in each of the dependent variables between treatment and withdrawal phases of the study. Were drop-outs reported? Did any participants drop out from the study? Why? Yes (Were reasons given and were drop-outs handled No X appropriately?) No dropouts, although several subjects were ill during the study and unable to participate as much as others. CONCLUSIONS AND What did the study conclude? What are the implications CLINICAL of these results for practice? What were the main IMPLICATIONS: limitations or biases in the study? Were conclusions The study demonstrated a measurable affect of microwave appropriate given study ovens on meal preparation and diet of elderly persons with methods and results? disabilities. The outcomes could have been affected by Yes X previous cooking experiences, the fact that subjects were No required to document information, making them more aware of what they were eating. The sample size is small, making generalizability to larger populations hard. REFERENCE Law, M., Stewart, D., Letts, L., Pollock, N., Bosch, J., & Westmorland, M. (1998). Critical review form for quantitative studies. Retrieved March 14, 2002, from http://www.fhs.mcmaster.ca/rehab/ebp.
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