Qualitative Article Critique on Palliative Care

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What is the research question? In "Palliative Care Nurses' Views on Euthanasia", Verpoort et al (2004) are inquiring "what are the views of palliative care nurses about euthanasia"? "It is essential to know how nurses, who are confronted with terminally ill patients every day, think about it." (Verpoort et al, 2004, p. 592). Verpoort et al have taken the stance that nurses are scarcely heard in debates on the legalization of euthanasia in Belgium, and that nurses "are in a position to offer valuable ideas about this problem" (Verpoort et al, 2004, p. 592). Verpoort et al (2004, p. 592) state, "the views of these nurses are important because of their palliative expertise and their daily confrontation with dying patients".

Would you say that the question is stated broadly enough for a qualitative study? This research question is appropriately broad enough for a qualitative study, allowing for a variety of concept interpretations.


What are the independent and dependent study variables? The dependent variable in Verpoort et al's (2004) "Palliative Care Nurses' Views on Euthanasia", is the view that the palliative care nurse towards euthanasia. The independent variables are the details of the patient situation including the patient's degree off suffering and available palliative options.

Study Design

What qualitative design was used? A grounded theory approach was used in this qualitative research design to better understand the views of palliative care nurses on euthanasia (Wester, 1987; Kuyper & Wester, 1998). In this article, face-to-face interviews were used involving an interview guide. The data was grouped into concepts according to significant passages, then the concepts were grouped into categories for continuous comparison, then the data was ordered through connections between categories and sub-categories. This process of analyzing data makes this process very easy to understand.

Setting and Sample

In what way is the method of obtaining subjects appropriate? Nurses were purposefully recruited from a palliative care unit, a palliative support team in a hospital and a palliative homecare team in Flanders to obtain a comprehensive and reliable picture of palliative care nurses' views on euthanasia (Verpoort et al, 2004). Participants of this study had to have worked at least one year in palliative care and be willing to share their views on the issue. Personal details of sample participants included age, gender, religious belief, work experience, nursing qualification and job function to create a heterogeneous sample. Person triangulation was attempted by having a sample with as much heterogeneity as possible.

In what way is the size of the sample used adequate? The sample consisted of 12 palliative care nurses with data collection based on principles of saturation.

In what way was the setting in which data were collected an appropriate one for this study? Face-to-face interviews were used with an interview guide. The interview guide was prepared to insure that basically the same information is obtained from each person, there are no predetermined responses, and in semi-structured interviews the interviewer is free to probe and explore within these predetermined inquiry areas. Interview guides ensure good use of limited interview time; they make interviewing multiple subjects more systematic and comprehensive; and they help to keep interactions focused. In keeping with the flexible nature of qualitative research designs, interview guides can be modified over time to focus attention on areas of particular importance, or to exclude questions the researcher has found to be unproductive for the goals of the research.

Data Collection Methods

In what way were the data collection procedures used consistent with the purpose of the qualitative approach selected? (Sim, 1999), recommends the following data be collected for a Qualitative Research study. What the participants say, how they interact with one another, and accurate attribution of quotations to individual group members. This was all done in this research study.

A grounded theory approach was used, with interviews with a convenience sample of 12 palliative care nurses in Flanders, Belgium. The data was collected between December 2001 and April 2002. Face to face interviews were done and questions were asked regarding the participants views on euthanasia and what argument they had for or against euthanasia. An interview guide was used and the questions were not asked in an orderly fashion. New questions were included based on the answers given by the interviewee to further explore and learn more about their opinions. This information was compared with answers conducted in previous interviews. A regular scheduled meeting was held with research supervisors and feedback was asked for from the participants regarding any unclear information that was obtained in the interview. The interviews were about an hour long at the participant's workplace in a quiet area (Verpoort, 2004).

The aim of the study was to explore the views of palliative care nurses about euthanasia. The data collection procedure was appropriate because the questions were open-ended and done in no particular order. If additional questions were needed depending on the answers already given, the additional questions were added to provide clarification of the participants view on euthanasia Verpoort, 2004). Participants received information about the researcher, the objectives, and the definition used for the subject, euthanasia.

In what way were the steps taken to protect the rights of subjects adequate? The significance of their participation and their legal rights with written consent were utilized. The institution and the participant's names were withheld and all of the data was confidential information. These were very important ethical steps that protected the participants in the study by keeping their answers confidential (Verpoort, 2004).

In what way are the data collection procedures appropriate for this study? Data collection was based on the principles of saturation and the total numbers of participant's were not fixed in advance (Polit & Hungler 1999). What evidence is there that data saturation was achieved? Following 12 interviews the data collection was suspended because themes and categories in the data became repetitive and redundant with no new information becoming available (Verpoort, 2004).

Data Analysis Methods

Data analysis methods for a Qualitative study includes keeping track of connections between data and requires cross-checking the information. Some Qualitative researchers believe the use of a computer is beneficial to provide quick and accurate data (Anderson, 1987; Miles & Huberman, 1994; Pateman, 1998; Taft, 1993).

In what way(s) are the data analysis procedures appropriate for the data collected and consistent with the qualitative method used? The data collection and analysis were done concurrently and use of the grounded theory approach was utilized Straus and Corbin (1990).Open-ended coding phases, with significant passages were noted and concepts allocated to words, sentences, or paragraphs. These concepts were associated with the participant's words and then grouped into categories through continuous comparison. In the axial coding phase the data as ordered by making connections between categories and sub-categories. QRS NUD*IST N4 was used in the coding process (Gahan & Hannibal, 1997).


Verpoort, C., Gastmans, C., & Dierckz de Casterle, B. (2004). Palliative care nurses' views on

euthanasia. Journal of Advanced Nursing, 47(6), pp. 592-600.