Nursing Research: Critique of an Article

This paper is a critique of Morrison & Yardley (2009) article titled: What infection control measures will people carry out to reduce transmission of pandemic influenza? A focus group study. In this article, the authors start by reflecting on the future health threat posed by pandemic influenza. They point out that infection control behaviors constitute an important defense. The researchers also point out the fact that little qualitative research has been done to examine the perceptions of various infection control measures as far as pandemic influenza is concerned.Nursing Research: Critique of an Article

Nevertheless, in the critique process, there are many articles with which this article by Morrison & Yardley (2009) can be compared, in terms of both methodology and findings. Such a comparison makes it easy for the identification of its strengths, weaknesses, and contribution to the pandemic influenza debate. In terms of methodology, Morrison & Yardley (2009) conduct one interview and complement it with eight focus groups.Nursing Research: Critique of an Article

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Through purposive sampling, 31 participants were selected. These participants were invited into a discussion on their perception of transmission of influenza and adherence to various measures of infection control. On these two issues, Morrison & Yardley (2009) focused on both pandemic and non-pandemic context, thereby appearing to cast their net too wide. This is particularly the case considering there are many control measures in each of these contexts, including social distancing, hand-washing, and cough hygiene. Each of these measures naturally attracts varying perceptions, and it is not surprising therefore that the authors did not cover them exhaustively.

Data analysis was carried out from a thematic perspective. The analysis showed that although most participants knew about infection transmission, majority had negative attitudes towards the control behaviors advocated for in non-pandemic situations. However, they expressed willingness to adhere to all infection control protocols if a pandemic broke out, as long as they are adequately educated about all aspects of control measures and practical support.Nursing Research: Critique of an Article

Moreover, there were some variations in the level of acceptability of various transmission control measures.  Handwashing was the most acceptable and it was also perceived as more feasible than social distancing and cough-and-sneeze hygiene. Morrison & Yardley (2009) concluded that hand-washing can be a valuable target in health promotion campaigns. However, there is also need for barriers of perceptions to be addressed with regard to other infection control measures (Morrison & Yardley, 2009).

In terms of scope, Morrison & Yardley are not as specific in their thematic and methodological scope as Chor (2009). Chor focuses on pre-pandemic contexts and only one control measure, that is, vaccination. For the sake of accuracy, to different questionnaire surveys are carried out. Chor found out that participants were willing to take pre-pandemic vaccination. It is possible to narrow down a scope even when a research study is being conducted across countries and continents. For instance, in Zwart’s (2007) study, focus was on risk perceptions in Asia and Europe, yet the researcher managed to interview 3,436 participants.Nursing Research: Critique of an Article

Nevertheless, Morrison & Yardley (2009) are right when they say that there is little qualitative research on the perceptions of various infection control measures for pandemic influenza. In many studies, qualitative research methods are avoided (Caley, Philp, & McCracken, 2008). There are many examples of this trend, including Raude & Setbon (2009) who carried out a national survey on the way the public perceive pandemic influenza threats in France. Another example is that of Imai & Takahashi (2008) who opted to use a quantitative research method in their study perceptions of different aspects of prepared among Japanese healthcare workers. In terms of themes and scope, Imai & Takahashi’s (2008) study closely resembles that of Morrison & Yardley. Just like in the case of the study by Morrison & Yardley, the study by Imai & Takahashi’s (2008) led to the emergence of one dominant variable: institutional preparedness.Nursing Research: Critique of an Article

Interestingly, Morrison & Yardley (2009) have achieved a high level of specificity in terms of scope compared to a number of related studies. For example, Seale & McLaws (2009) on the more general issue of how the Sydney community perceives pandemic influenza and swine flu. In this study, unlike that of Morrison & Yardley, attitudes and perceptions towards specific control measures are not explored in detail. In other words, they do not form a core part of the study. Therefore, issues such as attitudes towards infection control methods and quarantine are only mentioned in passing. The generalized approach in the study is inherent in the way the main outcome measures are defined. The main components of these measures include seriousness of disease, perceived personal risk, and views regarding the response of the government and health authorities.

In conclusion, as pointed out by Morrison & Yardley (2009), this is little qualitative research on the perceptions of various infection control measures as far as pandemic influenza is concerned. The article by Morrison & Yardley (2009) is a major contribution to literature on this subject. Although the article has some methodological and thematic weaknesses, the authors have made a significant scholarly contribution the debate on the perceptions of three core areas of influenza infection control, namely social distancing (quarantine), hand-washing, and cough hygiene.Nursing Research: Critique of an Article