In every piece of research, there must be a clear methodology that a researcher uses to gather and analyse data in order to generate relevant information on the topic under investigation. In this study, the focus was to determine the effectiveness of Manuka honey on wounds. The researcher conducted an extended literature review which involves a collective investigation of a specific issue using the available secondary sources. The research will involve systematic literature review.
According to Reswell (2003, p. 78), extended literature reviews have widely been used in the field of health as a way of knowledge creation among researchers and students. The project will involve evidence-based practice.
Crooks and Davies (1998, p. 112) define evidence-based practice as a system in healthcare where clinical practices are closely guided by evidence taken from published studies. These scholars say that as opposed to traditional methods, evidence-based practice emphasises on making decision based on the evidence and characteristics that are observable. It appreciates the dynamism in the environment and the need to use research as a tool to understand these changes (French 2002, p. 51).
In this research, it was important to investigate the changing patterns in the treatment of wounds using simple but effective approaches. In order to make decision as to the effectiveness of the Manuka honey in the treatment of wounds, the researcher considered it important to gather evidence from primary sources as a way of avoiding speculative conclusions.
This research is very important for nursing students and practicing nurses in various ways. To the students, the research offers a perfect opportunity of learning new knowledge that will be important once one gets into the practice. It offers them a perfect opportunity to have a broad knowledge on different topics by engaging directly in the process of data collection, its analysis, and drawing of conclusions.
To the practicing nurses, this research offers an opportunity to understand the changing patterns in the field of nursing (Grirish & Lacey 2006, p. 71).
For instance, other methods of treating wounds have been used in the past, and the practicing nurses are aware of them. But this research will offer a new knowledge on how Manuka honey can be used to treat wounds. This new knowledge is important in improving the efficiency of the practicing nurse (Keele 2011, p. 113). He or she will have a variety of methods to use when treating wounds. In literature review, methodology involves a specific procedure that is used in the collection and analysis of the relevant data.
The researcher used five articles in order to develop a generalisation about the topic of the research. These articles used different research designs in order to arrive at their conclusions. The three core articles used were quantitative in nature. They include the research by Thomas et al (2011), Jull et al (2008), and Schumacher (2004). According to Hart (2001, p. 94), quantitative research is an empirical study that uses numerical data techniques.
Quantitative study is important when there is need for statistical evidence in the study. The three articles by Thomas et al (2011), Jull et al (2008), and Schumacher (2004) are very important for this study. They take a phenomenological approach in explaining how Manuka honey has been used to treat wounds, confirming its efficiency as medical product. The scholars involved in conducting the research in the three articles are reputable researchers who have widely published peer-reviewed journals and books that reliably address relevant issues in the field of nursing.
Their works can, therefore, be trusted to hold high level of validity because of their experience in this field, and the research designs they used in these particular articles. The other two articles used mixed research approach. They include Robson et al (2009) and Mphande et al (2007). They also provide a rich source of information to the research topic.
The next step in this study would be the use of hierarchy of evidence in the identification of the type of literatures and the research designs which will be relevant in responding to our research questions (Hek, Langton & Blunden 2000, p. 56). Each principal type of research has a relative strength when compared to other types of research. As shown in the above hierarchy, randomised control trials are ranked top of the four types of research.
According to Parahioo (2006, p. 27), although there is no universally accepted hierarchy of evidence, scholars agree on the fact that emphasis should be laid on the relative strength of the epidemiological study. This makes randomised control trials to be ranked above all other observational studies, as shown in the rankings above (Macnee 2004, p. 56).
It is on this ground that the researcher chose to rely on articles that used randomised control trials. Out of the five core articles used, three of them had used randomised control trials. The article by Mphande et al. (2007) is a retrospective studies. Polit, Beck and Hungler (2001, p. 51) define retrospective studies as a research that seeks to compare a current issue with a past phenomenon. Retrospective studies enable a researcher to use medical records to know about the history of a given disease.
A researcher can alternatively conduct interview with a patient who is known to have had the disease in the past. This explains why this study is sometimes referred to as historical cohort study (Houser 2012, p. 71). The researcher considered the articles that used retrospective studies appropriate for this research because of the need to dig deep into the past treatment of wounds and how effective these methods have been. With this information, the researcher will be able to compare the effectiveness of these past medications with the new method that has been proposed to determine the one that is more effective.
This way, the conclusion made shall be based on factual information other than speculative thoughts (Polit, 1996, p. 73). However, it is important to note that majority of the core articles used in this study are randomised control trials. It is important to use randomised control trials in a research such as this because of its authority in delivering high quality studies. The researcher has done a hierarchy of evidence on four levels based on their rankings. Below is the ranking of the four epidemiological studies.
- Randomised control trials
- Systematic review
The five core articles chosen for this research will be critically analysed using CASP Tool. According to Tappen (2011, p. 81), CASP Tools for RCT are important in creating understanding of clinical trials. According to (Munhall 2012, p. 41), using a series of questions can be helpful in determining the validity of randomised trials.
The validity and reliability of the articles by Robson, Dodd and Thomas (2009) stratification by wound type, while reliability was assured by using efficient tools of analysis. In the research by Thomas, Hamdan, Hailes and Walker (2011), internal validity was achieved by avoiding personal biases.
Jull, Walker, Parag, Molan and Rodgers (2009) ensured statistical conclusion validity by determining the variations between cause and effect variables. Schumacher (2004), there was an attempt to achieve convergent validity by ensuring that all the operations in the study are similar. Mphande, Killowe, Phalira, Jones and Harrison (2007) achieved external validity by successfully generalizing their findings beyond the sampled population.
Introducing Finding Chapter
In this section, the researcher will conduct a summary of each of the five core articles that were used in this study. The researcher was interested in finding the best way of summarising the core articles in order to determine their research problems, the research designs used, data collection methods, the analysis of the data, the main findings, and the immerging themes. The summary table is shown below.
|Author (S) and Date||Research title||Research problem||Research design||Method of data collection||Sample||Analysis||Main finding||Immerging themes|
|Article A: Thomas, M, Hamdan, M, Hailes, S & Walker. M. (2011).||Manuka honey as an effective treatment for chronic pilonidal sinus wounds||To investigate effectiveness of Manuka honey in treating chronic PSD (pilonidal sinus disease).||A retrospective study||The data collection method involved an interview of the patients and reviewing past notes||18 patients||The honey therapy took 93 days and data collected were compiled and analysed retrospectively||15 of the 18 patients achieved complete healing of their wounds. Only two experienced recurrence of their wound||Minuka honey therapy is an effective way of treating chronic PSD.|
|Article B: |
Jull, A, Walker, N, Parag, V, Molan, P & Rodgers, A. (2009).
|Randomsed clinical trial of honey-impregnated dressings for venous leg ulcers,||To determine the efficacy of treating venous ulcers using honey||Randomised clinical trial||The method used to collect data was a community-based open label randomised trials (Jull et al 2008, p. 175)||368 patients||The researchers took 12 weeks to analyse the outcome of the treatment of venous ulcers using honey||The main finding is that honey was an expensive but effective way of treating venous ulcers.||Honey can be used to treat venous ulcers.|
|Article C: Schumacher, H. (2004).||Use of medical honey in patients with chronic venous leg ulcers after split-skin grafting||To investigate whether medical honey can be used in the treatment of chronic venous ulcers after conducting split-skin grafting||A retrospective study||Data was collected by interviewing patients who suffered from chronic venous ulcers in leg, underwent split-skin grafting then received medical honey (Schumacher 2004, p. 451)||6 patients||The researchers conducted an analysis of the data collected to determine the mean healing time for the chronic venous ulcers patients who went through skin grafting and then received medical honey as the main medication. The analysis also involved identifying any complications experienced in the process.||It was determined that the sampled patients took an average of 22 days to heal completely from their wounds.||From this article, it is clear that patients who went through skin grafting can be healed completely if they use honey as their medication.|
|Article D: |
Mphande, A, Killowe, C, Phalira, S, Jones, W & Harrison, W. (2007).
|Effects of honey and sugar dressings on wound healing||The researchers were interested in investigating whether there is a difference between use of honey and sugar when dressing wounds.||Randomised clinical trial||Data was collected from patients with open wounds in a randomised manner. Data on the progress of the healing process was taken on a daily basis.||40 patients. 18 of the received sugar treatment while 22 received honey treatment.||The researchers conducted an analysis on the progress of the two types of medication. The healing process of the wounds was recorded an analysed on a daily basis to determine how well the two medications were at healing the patients.||It was discovered that in the first two weeks of administering the two medications, patients given honey medications had their wound healing at 3.8cm²/week while those receiving sugar medication experienced 2.2cm²/week.||From this article, it is revealed that honey medication works better in healing wounds than sugar. After 3 weeks, 86% of the patients who received honey medication had their wounds completely healed compared to 72% of those who received sugar medication|
|Article F: |
Robson, V, Dodd, S & Thomas, S. (2009)
|Standardised antibacterial honey with standard therapy in wound care: randomised clinical trial||In this article, the researchers were interested in comparing the medical grade honey healing rate with that of conventional treatments (Robson, Dodd & Thomas 2009, p. 565).||Randomised clinical trial||In this study, data was collected from patients in a single centre in an open-label randomised controlled trial (Robson, Dodd & Thomas 2009, p. 565). The patients either received honey wound dressing or conventional one.||105 patients.||The research begun from September 2004 and ended in May 2007. The analysis of the treating power of the two medications was done on a weekly basis.||Within a period of 12 weeks, the healing rate for honey dressed wounds was 46.2% while that of conventional methods was 34.0%.||It was confirmed that honey was a better treatment of wounds than other conventional methods.|
List of References
Crooks, P & Davies, S 1998, Research into practice, Cengage Learning, New York.
French, P 2002, What is the evidence on evidence-based nursing: An epistemology concern, Journal of advance nursing, vol. 37. no. 3, pp. 250-257.
Grirish, K & Lacey, A 2006, The research process in nursing, Oxford Publishers, Oxford.
Hart, C 2001, Doing a literature review, Yarmouth Intercultural Press, New York.
Hek, G, Langton, H & Blunden, G 2000, Systematically searching and reviewing literature, Nurse researcher, vol. 7. no. 3, pp. 40-57.
Houser, J 2012, Nursing research: Reading, using, and creating evidence, Jones & Bartlett Learning, Sudbury.
Jull, A, Walker, N, Parag, V, Molan, P & Rodgers, A 2008, Randomized clinical trial of honey-impregnated dressings for venous leg ulcers, British Journal of Surgery, vol. 95. no. 1, pp. 175–182.
Keele, R 2011, Nursing research and evidence-based practice: Ten steps to success, Jones & Bartlett Learning, Sudbury.
Macnee, L 2004, Understanding nursing research: Reading and using research in practice, McGraw-Hill Irwin, New York.
Mphande, A, Killowe, C, Phalira, S, Jones, W & Harrison, W 2007, Effects of honey and sugar dressings on wound healing, Journal Of Wound Care, vol. 16. no. 7, pp. 317-319.
Munhall, P 2012, Nursing research: A qualitative perspective, Jones & Bartlett Learning, Sudbury.
Parahioo, K 2006, Nursing research: principles, process and issues, McMillan Publishers, London.
Polit, F & Beck, T 2008 Nursing research: generating and assessing evidence for nursing practice, McGraw-Hill Irwin, New Delhi.
Polit, F, Beck, T & Hungler, P 2001, Essentials of nursing research: methods, appraisals and utilization, McGraw-Hill Irwin, New Delhi.
Polit, F 1996, Data analysis & statistics for nursing research, Appleton & Lange, Stamford.
Reswell, J 2003, Research design: qualitative, quantitative and mixed methods approaches, Wiley, New York.
Robson, V, Dodd, S & Thomas, S 2009, Standardized antibacterial honey with standard therapy in wound care: randomized clinical trial, Journal of Advanced Nursing, vol. 65. no. 3, pp. 565–575.
Schumacher, H 2004, Use of medical honey in patients with chronic venous leg ulcers after split-skin grafting, Journal of Wound Care, vol. 13. no. 10, pp. 451-452.
Tappen, R 2011, Advanced nursing research: From theory to practice, Jones & Bartlett Learning, Sudbury.
Thomas, M, Hamdan, M, Hailes, S & Walker, M 2011, Manuka honey as an effective treatment for chronic pilonidal sinus wounds, Journal of wound care, vol. 20. no. 11, pp. 528-533.