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Paper Outline
Title: Journal Analysis

I.

Body
Main Point: Literature Review, Theoretical Framework, and Research Questions.
Examples/Details/Explanations:
a. Background.
b. Philosophies
c. Theory recommendation.

Main Point: Methodology
Examples/Details/Explanations:
a. Type of study.
b. deductive aspect.
c. Probability subjects selection.

Main Point: Data collection.
Examples/Details/Explanations:
a. Semistructured methods.
b. Study phases.
c. Ethics.

Main Point: Data analysis.
Examples/Details/Explanations:
a. Data analysis tool.
b. Saturation.
c. Results presentation.
d. Data coding.

e. Finding.

Main Point: Summary, Implications, and Recommendations
Examples/Details/Explanations:
a. Themes accuracy.
b. Insights.
c. Weaknesses and strengths
d. Conclusion and recommendations,


1

Journal Analysis

Student's Name
Institution Affiliation
Course
Professor's Name
Date

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Journal Analysis
Literature Review, Theoretical Framework, and Research Questions
The authors analyze different pieces of literature in the background section to provide an
in-depth delineation of the integrity concept through a scholarly dimension. They first provide a
detailed explanation of what integrity stands for to familiarize the audience with the issue they
are addressing. They then proceed to develop the idea further with various types of scholarly
articles that give distinct perspectives of the ICU integrity, such as code of ethics and features.
The resources utilized are a mixture of both old and recent publications. This is because the
authors wanted to give a wide range of opinions for consistency and accuracy as concepts change
with time. They utilized some sources from the 90s, early 20s, and most recent ones. As they
analyzed the literature, the authors incorporated their interests as a reflexivity move. For
instance, they acknowledge that scholars differ on the integrity concept, but the nurses do not
relate with most of the offered perspectives.
The study utilizes philosophical and legal ideologies to give background to their study
phenomenon. They argue about integrity as a personal sphere, character trait, and wholeness.
These virtues align with the integrity in terminally ill ICU patients as this kind of practice is
sensitive and brings out a nurse's full integrity potential. The literature review also leads to the
study hypothesis, which states the research's aim. However, the study does utilize a robust theory
and needs theoretical support to augment the literature review. Deontological ethics theory
would be an ideal framework for the study. According to Tseng et al. (2021), Immanuel Kant,
the pioneer, asserts that all people deserve respect and dignity. This is an excellent approach to
ethics as it recommends how nurses should treat their ICU patients despite being in the last days
of their lives.

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Methodology
This is a qualitative study that addresses the phenomena of nursing integrity in the
intensive care unit. The main aim is to understand the nursing integrity concept deeper.
According to the background information, integrity in nursing is an underrated feature. Further, it
asserts that despite delivering intensive care to patients in the ICU, the nurses have limited
knowledge of how to incorporate integrity in their service to patients at the end phases of their
lives. Thus, the approach dimension makes it a qualitative type of study. The other characteristic
of the research is that it seeks to understand the nurses' perceptions and attributes of intensive
care for terminally ill patients. Thus, it is a descriptive type of research based on nursing
intensive care unit diagnostics.
The research also employs a deductive study perspective whereby it aims to understand
the integrity in the ICU. Integrity is a standard facet of healthcare and not an alien concept. The
research only seeks to augment the integrity comprehension in ICU nursing due to the limited
focus accorded to it. In representing a wider audience, the study utilizes a random selection
method to attain a comprehensive representation of the entire population through the outcomes.
The study relies on four Sweden ICUs as the study facilities; three dealing with central care and
one based on thorax complications. These facilities offer a wide variety of study subjects as the
CICUs take care of various patients such as surgery complications, trauma, infectious and acute
medical disorders, while the thorax unit deals with all types of cardiological complications. The
single nurse allocation per patient is another feature that strengthened the study randomness as
each nurse had a different experience with the different kinds of ailments taken care of in the

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ICU. The study sample size entailed sixteen nurses comprising one male and fifteen ladies, and
the experience level was nursing practitioners with an experience of one year.
Data Collection
The authors were tactical in conducting the research by employing a semi-structured
study method to collect detailed information. It is a flexible data collection method that does not
stick to fixed inquiries but only sets the direction through broad questions and gives room for
more explication by the subjects. The open-ended system is viable in providing better explication
opportunities that often lead to profound disclosures. Despite utilizing only semi-structured
questions as the primary type of data collection, the author conducted the research into two
phases comprising a pilot stage and the actual interview. The pilot stage provided room for
explanation of concepts and identification of flaws for correction before the principal interview.
The two phases create a triangulation effect whereby augments the study plausibility. Despite the
questions being open-ended, they were highly probing through follow-up prompts. For instance,
the author would ask the subject to elucidate more on their response and further inquire for an
example of the situation or idea. In ensuring data adequacy and accuracy, the authors conducted
the interviews at the ICU offices with a serene environment and took an ample time of an hour
with each nurse. Further, they recorded the ongoing discussions to capture all the details and
transcribed them to ensure that they were available in different formats of print and audio. Ethics
was another issue the authors gave prominence to in their study. They complied with the
proposed checklist by qualitative research reporting standards. They also employed beneficence
by only reaching out to the ICU authorities and letting the qualified and willing nurses choose to
participate without coercion.
Data Analysis

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The study engaged all the authors in data analytics for collaborative analysis. The unified
effort combined various skills as all the researchers possess expertise in qualitative study results
interpretation. They primarily utilized the Latent inductive content analysis data tool to evaluate
the subjects' outcomes. It was the most suitable tool for this study as it helps decipher deep and
complex meanings in recording and printed material. They commenced the analysis through
repetitive listening sessions of the results, followed by marking and shortening units. After that,
they coded the condensed units, contrasted the data, and finally labeled it as the final outcome
after all authors cohered to the results. The final analysis of data and consensus that the results
could not be overanalyzed further indicates a saturation point. In presenting the results, the
authors utilized five metrics to assess the nurses' integrity towards their ICU patients. They
involved patient uniqueness, vulnerability sensitivity, mental and physical wellbeing, culture and
religion, and respect. In one of the most crucial outcomes, the authors noted that the nurses could
not adequately outline integrity in ICU care.
Summary, Implications, and Recommendations
The five thematic metrics were crucial in directing the outcomes of the research. They
captured every aspect of health for the dying ICU patients and the treatment they receive from
nurses. They yielded robust results, which confirmed that integrity is vital for all nurses attending
to patients at the end of their lives. Despite facing challenges elucidating the integrity concept,
the nurses cohered that they must accord a better treatment to those patient-centered approaches
that align with the philosophical postulations. The open-ended questions also allowed the nurses
to discuss the challenges they face in the struggle to treat the dying patients with integrity. They
argued that the ICU medical technicalities created a depersonalization effect where patients felt
unworthy. They also reported struggling with family interference as the family may try to charge

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of the treatment decisions and insist on spending more with the patient, which is impossible due
to the ICU environment, which cannot accommodate a higher number of people for a long time.
The nurses also argued disagreements with the other medical practitioners in the ICU due to their
extreme care, which they termed therapeutic obstinacy. Cultural and religious barriers were other
impediments hindering nursing integrity. These outcomes show that the study successfully
represented a vast population through the random sampling offered by the different ICU units
offering various final life moments intensive care. However, the study was gender-biased as the
authors recruited more female subjects than males. It is also a neglected area of research that
only limited them to descriptive research methods. In culminating the study, the authors assert
that they cannot make any concrete recommendation as there is a need for more focus on the
issue. However, they emphasized the nurses' unawareness of the integrity virtue and advocated
for patients' beliefs and values discernment.

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References
Palmryd, L., Rejnö, Å., & Godskesen, T. E. (2021). Integrity at the end of life in the intensive
care unit: a qualitative study of nurses' views. Annals of Intensive care, 11(1), 1-10.
10.1186/s13613-021-00802-y
Tseng, P. E., & Wang, Y. H. (2021). Deontological or utilitarian? An eternal ethical dilemma in
Outbreak. International journal of environmental research and public health, 18(16),
8565. https://doi.org/10.3390/ijerph18168565

View attached explanation and answer. Let me know if you have any questions.Here is the article

(2021) 11:23
Palmryd et al. Ann. Intensive Care
https://doi.org/10.1186/s13613-021-00802-y

Open Access

RESEARCH

Integrity at end of life in the intensive care
unit: a qualitative study of nurses’ views
Lena Palmryd1,2, Åsa Rejnö3,4 and Tove E. Godskesen2,5*

Abstract
Background: Integrity is a core value for delivering ethical health care. However, there is a lack of precision in defining what integrity is and how nurses understand it. In the setting of nurses caring for critically ill and dying patients in
intensive care units (ICUs), integrity has not received much attention. Therefore, the aim of this study was to explore
how nurses perceive and maintain the integrity of patients during end-of-life care in the ICU setting.
Methods: This study had a qualitative descriptive design. Data were collected using individual semi-structured interviews with 16 intensive care nurses working at ICUs in four Swedish hospitals. The data were analysed by applying
qualitative content analysis.
Results: Five overall categories were explored: seeing the unique individual; sensitive to patient vulnerability; observant of patients’ physical and mental sphere; perceptive of patients’ religion and culture; and being respectful during
patient encounters. Many nurses found it difficult to define integrity and to explain what respecting integrity entails in
the daily care of dying patients. They often used notions associated with respect and patient-centred attitudes, such
as listening and being sensitive or by trying to describe good care. Integrity was nonetheless seen as a central value
for their clinical work and a precondition for ethical nursing practice. Some nurses were concerned about patient
integrity, which is at risk of being “wiped out” due to the patient’s illness/injury, unfamiliarity with the ICU environment
and utter dependence on others for care. Protecting patients from harm and reducing patient vulnerability were also
seen as important and a way to maintain the integrity of patients.
Conclusions: The study results show that even though integrity is a fundamental ethical concept and a core value in
nursing, ethical codes and guidelines are not always helpful in clinical situations in the end-of-life care of ICU patients.
Hence, opportunities must regularly be made available for ICU nurses to reflect on and discuss ethical issues in terms
of their decision-making and behaviour.
Keywords: End-of-life, Ethics, Integrity, Intensive care, Nursing care, Palli...