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Research Critique: The silence of mental health issues within university environments: A quantitative study

The aim of this study was to examine the attitudes and experiences of staff and students towards mental health problems. Background of the study shows that more than 20% of the university population have experienced a mental illness during their college years. Mentally ill students confirm common mental health problems due to the distress they experienced while in college.

What was noteworthy in this study is the level of distress that mentally ill students suffer, which are higher than the general population.  The use of descriptive analysis was appropriate to provide individual’s experiences and feelings of what is like to be a college student with a mental disorder.

Furthermore, the study provided another perspective in dealing with a mental disease, perceptions from the general population about the disease and the mentally ill patient who is trying to live a normal college life. The study conducted a survey at two Australian universities.

Data was collected from 270 staff who were asked to complete a 20 questions survey called “Attitudes Towards Mental Illness”, with four comprehensive categories: fear and exclusion of people with mental illness, understanding and tolerance of mental illness, integrating people with mental illness into the community, and causes of mental illness; 201 students, who self-identified as having a mental health problem, were to take a 10-minute survey with a three-factor structure: Discrimination, disclosure, and potential positive aspects of mental illness.

Results of this study shows that tolerance around people with mental illness is high and they should not be excluded or treated in a different way. Another highlighted result is that individuals with mental issues experienced discrimination across all their college years and, thus, they are afraid to disclose their mental problems.

Despite the acceptance and awareness of mental health problems the study clearly demonstrated that avoidance or silence among patients and general university populations is the biggest barrier surrounding mental health problems. The study showed evidence that health professionals engage in some level of discrimination against patients with mental health problems. As a result, the nursing profession should develop a permanent strategy to ensure mental health literacy among healthcare providers. Overcoming social problem requires empathy, compassion, education, and an open-hardheartedness from the ill person and all other individuals involved.

Citation:

Wynaden, D., McAllister, M., Tohotoa, J., Omari, O. A., Heslop, K., Duggan, R., & … Byrne, L. (2014). The silence of mental health issues within university environments: A quantitative study. Archives of Psychiatric Nursing, 28(5), 339-344.

Aspect of the Report Critiquing Questions Answer

Yes/No

Comment(s)
Title Is the title a good one, succinctly suggesting key variables and the study population? Yes Yes, the article states to be a quantitative study assessing the silence on mental issues at universities.
Abstract Did the abstract clearly and concisely summarize the main features of the report (problem, methods, results, conclusion)? Yes Yes, the abstract concisely summarizes the problem, method used to gather data, results, and conclusion to this study to the attitudes towards mental illness in universities and the stigma around this illness.
Introduction

Statement of the problem

Was the problem stated unambiguously, and was it easy to identify?

Is the problem significant for nursing?

Did the problem statement build a persuasive argument for the new study?

Was there a good match between the research problem and the methods used – that is, was a quantitative approach appropriate?

Yes The article clearly states the problem and it was easy to identify. The problem is significant to nursing and more specifically to psychiatric nursing and how nurses can help identify mental problems and coping mechanisms to mental ill patients. The problem is relevant to college students who are trying to complete their studies while managing an existing mental disease.

The problem statement is persuasive enough to catch the reader’s attention. The word “silence” as part of the problem statement hook the attention to understand the magnitude of the issues that mentally ill students have to confront in order to be able to complete their studies.

The study used a quantitative approach. However, the research problem and the study method used qualitative data to provide quantitative results. As a result, this study inappropriately used the quantitative approach to analyze survey’s results. Although the survey contains quantitative data as such, this data is not valid nor replicable if a similar study were to take place. This article uses qualitative data and attempts to transform it into quantity by utilizing descriptive statistics.

Hypotheses or research questions Were research questions and/or hypotheses explicitly stated? If not, was their absence justified?

Were questions and hypotheses appropriately word, with clear specification of key variables and the study population?

Were the questions/hypotheses consistent with existing knowledge?

No A research questions in this study is absent and justified by the nature of the problem statement.
Literature review Was the literature review up-to-date and based mainly on primary sources?

Did the review provide a state-of-the-art synthesis of evidence on the problem?

Did the literature review provide a strong basis for the new study?

Yes Literature review is embedded in the introduction to provide background and relevant information to the study. The literature review is up-to-date and provide an overview and background to the problem statement. Citations are relevant and justifiable. Cited researchers made a point to note that mental illness is a silent stigma among students.

The review provides a state-of-art synthesis that aid the reader familiarize with the study and its purpose.

The literature review provides a strong basis for a new study.

Conceptual/theoretical framework Were key concepts adequately defined conceptually?

Was a conceptual/theoretical framework articulated – and, if so, was it appropriate? If not, is the absence of a framework justified?

Were the questions/hypotheses consistent with the framework?

No No conceptual framework or additional key concepts were identified in this study.
Method

Protection of human rights

Were appropriate procedures used to safeguard the rights of study participants?

Was the study externally reviewed by an IRB/ethics review board?

Was the study designed to minimize risks and maximize benefits to participants?

Yes The study used appropriate procedures to safeguard the ethical rights of their participants.

Ethical approval was obtained from two universities to conduct this research. Participants freely contributed to the study and they obtained contact information of the researchers, as well as support and counseling services were offered.

Research design Was the most rigorous design used, given the study purpose?

Were appropriate comparisons made to enhance interpretability of the findings?

Was the number of data collection points appropriate?

Did the design minimize biases and threats to the internal, construct, and external validity of the study (e.g., was blinding used, was attrition minimized)?

No For this study, the researcher used descriptive statistics to show the intensity, behaviors, attitudes, fears, and understanding of the problem. Causality of the problem stated was preceded by the effect in the study.

The data collection points were appropriately organized to meet the desire purpose of the study. However, prejudice, biases, and a low participation rate reduce the validity of the study.

Population and sample Was the population identified? Was the sample described in sufficient detail?

Was the best possible sampling design used to enhance the sample’s representativeness? Were

sampling biases minimized?

Was the sample size adequate? Was the sample size based on a power analysis?

Yes Target population for this study was clearly identified. Details of the sample were described in the details section. Data was collected from 270 staff who were asked to complete a 20 questions survey; and 201 students, who self-identified as having a mental health illness. Sample size was adequate, and results yield to valid findings. Researcher in this study used power analysis to target and estimate their sample size needs.
Data collection and measurement Were the operational and conceptual definitions congruent?

Were key variables measured using an appropriate method (e.g. interviews, observations, and so on)?

Were specific instruments adequately described and were they good choices, given the study population and the variables being studied?

Did the report provide evidence that the data collection methods yielded data that were reliable, valid, and responsive?

Yes Surveys were collected, protected, and secured. Accessed to data was only allowed by two members of the research team. Surveys were appropriate, safeguarded and reliable during the study. Classification of participants and aids to minimize biases during analysis.
Procedures If there was an intervention, was it adequately described, and was it rigorously developed and implemented? Did most participants allocated to the intervention group actually receive it? Was there evidence of intervention fidelity?

Were data collected in a manner that minimized bias? Were the staff who collected data appropriately trained?

No There were no interventions develop or implemented during this study.  Data was collected by using Survey Monkey, an internet resource.
Results

Data analysis

Were analyses undertaken to address each research question or test each hypothesis?

Were appropriate statistical methods used given the level of measurement of the variables, number of groups being compared, and assumptions of the tests?

Was a powerful analytic method used? (e.g. did the analysis help to control for confounding variables)?

Were Type I and Type II errors avoided or minimized?

In intervention studies, was an intention-to-treat analysis performed?

Were problems of missing values evaluated and adequately addressed?

Yes Results were clearly stated, Variables, comparisons, and assumptions were appropriately analyzed.  Descriptive statistics successfully addressed the research statement in this study, which is primarily descriptive. Relationship was determined between students with mental health problems and their experiences of discrimination and stigma. Data was analyzed by the Statistical Package for Social Science Version 22.0. Type I or Type II were not committed due to the nature of the study. During this study students, were encouraged and able to obtain professional support from counseling services at each university.
Findings Was information about statistical significance presented? Was information about effect size and precision of estimates (confidence intervals) presented?

Were the findings adequately summarized, with good use of tables and figures?

Were findings reported in a manner that facilitates a meta-analysis, and with sufficient information needed for EBP?

Yes Statistical information was adequately summarized with tables and summary of results. Responses were identified in types and scales. Explicit and sufficient information were provided to understand evidence of the study.
Discussion

Interpretation of the findings

Were all major findings interpreted and discussed within the context of prior research and/or the study’s conceptual framework?

Were causal inferences, if any, justified?

Was the issue of clinical significance discussed?

Were interpretations well-founded and consistent with the study’s limitations?

Did the report address the issue of the generalizability of the findings?

Yes A major finding of both surveys was the silence associated with mental health problems. Prior research shown that university populations are experiencing similar experiences. Interpretation of this study was well-founded by prior research. Limitations were connected to the main focus of the study, silence around mental health problems.
Implications/

recommendations

Did the researchers discuss the implication of the study for clinical practice or further research – and were those implications reasonable and completed? Yes Although results do not implicate other university’s population opinions, the author discuss the main implications of the study to warrants further research.
General Issues

Presentation

Was the report well-written, organized, and sufficiently detailed for critical analysis?

In intervention studies, was a CONSORT flowchart provided to show the flow of participants in the study?

Was the report written in a manner that makes the findings accessible to practicing nurses?

Yes The article report is very well organized, sufficient details provided for analysis. Tables and graph were appropriately labeled and relevant to the study. Written language used was accessible to practicing nurses.
Researcher credibility Do the researchers’ clinical, substantive, or methodologic qualifications and experience enhance confidence in the findings and their interpretation? Yes Researchers involved in this study provided reasonable qualifications and experience to ensure credibility in this study.
Summary assessment Despite any limitations, do the study findings appear to be valid – do you have confidence in the truth value of the results?

Does the study contribute any meaningful evidence that can be used in nursing practice or that is useful to the nursing discipline?

Yes Despite limitations this study appears to be valid, transparent, and reliable. This study contributes to the nursing practice to have a better understanding of mental illnesses and how college students and university staff deal with these diseases.

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