Posted: June 21st, 2015

Malnutrition amongst the elderly in a hospital setting compared to those in home care setting

This is a literature review. Sometimes a literature review is the research and there is no additional collection of new data. Objectively assembling, synthesising and analysing what is known about a topic and the strength of that knowledge is important in itself. This module is entirely about undertaking a literature review. There is no requirement to collect new data.

Write a dissertation on the above topic (Malnutrition amongst the elderly in a hospital setting compared to those in home care setting). NOTE: please I need to know what question you formulate from the topic before you commence writing.
It takes the form of a critical review and discussion of the literature using an explicit search strategy of a wide range of a minimum of 10 primary sources and where appropriate secondary sources pertaining to the subject under investigation. A primary source is a piece of original research that directly investigates a particular topic. A secondary source is an article that reviews or comments on a range of primary sources.

This module requires you to undertake a literature review – the dissertation. You need to choose a topic of interest concerning nursing or healthcare and about which there is some existing research.

 

Learning Outcomes

By the end of this module you should be able to:

 

1. Articulate a clear research question for your review and provide a rationale for selecting the topic.

 

1. Demonstrate the ability to complete a systematic and comprehensive search of the literature drawing on current and relevant sources. This will also include the ability to organise the literature retrieved and explain how you selected the literature included.

 

1. Rigorously appraise research articles demonstrating understanding of the methodology and/or relevant theoretical frameworks.

 

1. Construct critical and reasoned arguments which analyse, evaluate and summarise the literature in an objective way.

 

1. Exhibit critical insight into ethical issues that relate to the topic of enquiry and or emerge from particular papers.

 

1. Draw appropriate conclusions with recommendations for the development of practice or policy and the identification of areas requiring further research.

 

Structure of the Dissertation

Introduction

The introduction needs to place the research question or topic in context. In particular, this part of the dissertation needs to explain and justify the focus on the chosen topic and the particular aspect of that topic which is concentrated upon. This might be in terms of the seriousness of a particular condition, its policy importance e.g. UK policy on end of life care, its prevalence, cost to the National Health Service, some continuing uncertainty about the most effective way to treat a particular problem or the organisation of the workforce etc.

This needs to be done with reference to relevant literature and should convince the reader that the dissertation is worthwhile i.e. it should be informed by current debate and capable of generating interesting findings. You may need to explain some key terms or concepts to the reader if you think that they are not generally known. Ensure the aims and objectives are clearly defined and explained. This is a criterion that is often poorly addressed.

 

Method

Detail how data sources were selected (types of manual search which databases and/or search engines you used) search terms and which inclusion and exclusion criteria used (See relevant chapters in key texts). As stated earlier we recommend you create a Summary Table to set out various characteristics of your included studies. The information in your chosen studies. This table must be included as one of your appendices. .

The advantages of such a table is that it summaries key elements of the studies, helps your understanding because until you get to grips with the content you cannot compare & contrast studies in the literature review section. A logically laid out table also enables you to see at a glance the range of studies and research methods in your selection of studies. In addition it also helps you to identify the main characteristic of the research that you will be exploring in your literature review section.

If a critical appraisal framework (see My Learning for example) is used then it should be identified and justification of use outlined. Your supervisor will direct and support you in effectively using the frame work to critique the papers included.

 

Literature Review (your appraisal of the papers)

Results/findings: This main section of the dissertation presents the papers included. We recommend introductory comments about the literature as a whole followed by the detailed presentation and critique of each paper. This would include general comments about the nature of evidence itself – is it largely qualitative, quantitative or a combination of both? Is there high or low consensus? Are there different schools of thought?

After this comes the detailed presentation of the papers. One approach is to divide and discuss the papers in groups. You can divide the papers into groups depending on, for example, their findings or their methods. You can think of findings-based groups as something like the ‘themes’ that qualitative researchers sometimes use to organise a large amount of collected data. You can use the themes as subheadings. Alternatively you could divide them according to some methodological criteria, for example groups of studies that used different measures of job satisfaction, or burnout. Alternatively you could divide them by their findings e.g. one group of studies that found a certain intervention was effective and then those which found it ineffective.

In this section we would expect the following:

 

• The context of each of the studies e.g. ‘… in a small qualitative study carried out in a primary health care setting in England in the late 1990s…’
• A brief summary of the methods used in each paper and a comment, if appropriate, on the limitations of this e.g. very small or unrepresentative samples, poorly defined concepts, lack of detail about methods (the most likely limitation), conclusions which do not follow from findings. A summary of the findings of each paper.

 

Discussion

Following the presentation and critique of the papers we expect a general discussion of what that collection of papers have told us. This section of your dissertation should summarise the overall outcome of the review. It should pose the question What do we now know about this topic? The discussion section should include the following:

 

• Discussion of major areas of agreement and disagreement in the literature. Relate to wider context
• Strengths and limitations of the literature as a whole e.g. were the studies generally small and of poor quality?
• A reflection on your overall approach to the review e.g. limitations of time, resources, experience, access to literature (small amount, difficulties finding) –how did these impact on the quality of the review that you carried out? By identifying the limitations this will help to put your results in context/perspective.
• Crucially the relevance and importance of the overall findings to practice, policy, education, workforce planning etc. Any Recommendation or implications for practice where appropriate should be thoroughly discussed (see marking criteria). This is a key subsection.

 

Conclusions

This section should answer the question: What answers or new insights have you given them into the area and the research question?

The conclusion section should include the following:

• Summarise clearly the main findings of the review in relation to the research question.
• Summarise any implications for practice/policy/organisation of care or education where appropriate.

• Avoid the conclusions being a mere summary of what has gone before. You should try to progress ideas in this section in light of the overall research question. What about any unanswered questions?       It may not always be possible to fully answer your question. This could be due to limited research in the area you have chosen. If so, then this should be acknowledged. Suggestions for future research in the area should be identified- e.g. more qualitative/quantitative studies, larger studies, questions for future research arising from the study (especially where you have discovered a paucity of published evidence).

 

Referencing

 

Referencing should follow the School of Health and Social Science Guidelines which are available from the Learning Resource Centre. The crucial points are that your referencing needs to be complete (both in terms of including every paper and every necessary detail for those papers) and consistent in style.

 

Overall structure

The above are all vital components of a dissertation. However, to produce a good quality dissertation, the whole is more than the sum of the parts so all of the above need to come together to serve the development of the overall argument. This means the structure should be logical and the sections need to link with each other so that they play their part in achieving the overall objectives of the dissertation. For example check that the end of each section summarises its role and explains how the next section follows on.

 

In order to achieve this, it is vital that you produce a first draft (or more!) so that there is plenty of time to significantly edit or remove any unnecessary sections and tighten up the whole piece for the final copy. Please PROOF READ work prior to submission.

 

Ethics

Ethical approval is not required for a literature review. However you should discuss ethics and research governance frame work, whether all the papers cited obtained ethical approval (if they are research-based) and critique any ethical issues identified with regards to aspects of the research design (e.g. ethics questionnaire, interviews etc.) or your area of enquiry. Confidentiality regarding clients/patients and clinical area should also be respected (see appendix 5).

Remember addressing ethical issues relevant to your area of inquiry is one of the marking criteria.

 

 

Presentation

• This is an academic piece of work and therefore should be written and presented as such.

Binding	Suggest ring binding with transparent plastic covering pages.Access general stationery shop.
Title page	Title of your dissertation; name, student number, module title & code, name of supervisor, stream, branch, module leader and word count.   A note entitled: “ This study is submitted in part fulfilment of the requirements of the degree of …………………”. At the bottom (footer) of the page the name of Middlesex University and the year in which the dissertation is to be examined.
Acknowledgement	If appropriate brief expressions of thanks to individuals who have been very helpful with your dissertation e.g. your supervisor, subject specialists who have advised you.
Abstract	A summary of the whole dissertation. It should not exceed 200 words.The abstract should include the main aims of the dissertation, brief background information to set the scene, your research question, methodology used to explore the question/problem, main findings/results, conclusions and significance of these.
Content List	These are your section headings with page numbers. Any figures, tables, lists of abbreviations; main body of the dissertation; references and appendices.The content list can be quickly generated using a word processor.
Body of Dissertation	Introduction, Methods (search strategy), Critical Review of the Literature, Discussion, Recommendations for Practice, Research, Education, Conclusions. You may also want to include subsections relevant to your area of inquiry.
Referencing	Site them well
Appendices	Placed after the list of references. All appendices should be clearly labelled and include log book, summary table of studies, consideration of ethics and research governance form and any other appropriate information.
Typography	Line spacing 1.5 and 4cm margins on the left hand side.All pages must be numbered. Diagrams and figures should be numbered, have a title, legend and sources used in compiling them acknowledged.
Academic writing	Clear coherent and concise use of language. Correct grammar, spelling and syntax. Please proof read work.