Nowadays, the feasibility of pain management and mitigating the negative effects of numerous diseases with the help of medicinal marijuana remains one of the important and contradictory questions discussed by specialists related to nursing and medicine. As for the situation in the field, it can be said that there is a lack of qualitative studies related to the effectiveness of medicinal marijuana as researchers primarily use quantitative research methods to demonstrate the use of more objective data. The article chosen for the given paper is the most recent review of qualitative articles on the topic that was conducted by Ryan and Sharts-Hopko (2017).
Introduction and Literature Review
In the introduction section, the authors mention a wide range of facts, illustrating the popular opinion concerning the use of cannabis for medical purposes. What is more, they provide the information, allowing the reader to conclude the history of cannabis as a medicinal drug. To make the introduction more informative and attract more attention of the readers, the researchers refer to the findings reported by famous authors and professional organizations interested in the problem. Thus, the organizations mentioned by the authors include AAN and AMA.
Before conducting a study, any researcher needs to define the rationale and formulate the reason why such a study would make a positive contribution to the field. As for the rationale chosen by Ryan and Sharts-Hopko, the authors suppose that the clue allowing to define whether medicinal marijuana can be used on the global scale is closely associated with the personal experience of patients and the way that they perceive the effects of such treatment.
At the same time, it is clear that the authors indicate that many healthcare providers are likely to neglect the subjective experiences of patients while assessing the effectiveness of marijuana for pain management and reducing anxiety. Believing that conducting a qualitative study is the best way to understand various experiences of patients, the authors suppose that the review of such studies can help to identify common findings and, therefore, make more objective conclusions on the effectiveness of marijuana as a medicine based on perceptions of patients. I suppose that the authors present an adequate rationale for conducting the study because the attempts to generalize personal experiences that are rather subjective often help to single out the findings able to provide the objective knowledge related to a certain topic.
More than that, reviews using studies that were conducted by researchers from different countries can also help to identify the links between the patients’ experience and their cultural characteristics, and it extends the range of topics for further research.
The significance of the study is inextricably connected with the fact that the authors were focusing on experiences reported by patients. Thus, it can be supposed that the given study makes a significant contribution to the field because it fulfills two important tasks; apart from reviewing experiences of patients reported by previous researchers, the study provides a discussion of factors such as the legality of marijuana and the previous experience of recreational use of cannabis which have an impact on patients’ opinions on its effectiveness. I suppose that the difference that it can make to the field is its ability to attract more attention to the subjective experience of patients and the fact that it reflects characteristics of cannabis as a drug.
The literature review is thorough and comprehensive as comparing and summarizing other researchers’ findings was the primary purpose of the article. Also, the articles were chosen based on the range of criteria. I suppose that the authors do not demonstrate any potential biases in their review because they were excluding inappropriate articles based not on their conclusions but on the degree to which the works were related to the topic. Apart from that, I believe in authors’ impartiality as they do not express a clear opinion on the appropriateness of medical use of cannabis. Also, all articles chosen for the review were analyzed by the same questions, and it excludes the possibility of data fudging.
In the introduction section, the researchers also define the basic concepts utilized throughout the article. For instance, they reflect on the effects that medical marijuana is believed to produce on the mental and physical health of patients. Moreover, the authors thoroughly explain the basic terms related to the topic, for instance, types of cannabinoids and the way they are produced.
Apart from that, the authors of the article describe methods used by specialists from professional medical organizations who were likely to neglect the long history of cannabis used to manage pain, stabilize the mood, or fulfill other tasks. For instance, they present the information on studies that have declared cannabis to be addictive and useless as a medicinal drug. Paired with the statement concerning the necessity to focus on the experience of patients, this information enables the readers to better understand the purpose of conducting the study.
The Purpose Statement
As for the study, it is explained in a short section of the discussed article. According to the authors of the research, the purpose of the article is to review qualitative studies devoted to the use of cannabis for medical purposes. As it is clear from the following sections, these purposes include different tasks such as pain management. Apart from that, the authors make one more statement to identify the aims of the study more clearly. Thus, they highlight that the review is supposed to help them to identify common points between the findings reported by different researchers. According to the authors, they need this information to single out the basic themes, and it proves the qualitative nature of the discussed review: thematic analysis is believed to be one of the most effective methods in qualitative research.
It is difficult to define whether the purpose statement is based on the argument that is developed in the previous section because the authors express a range of ideas in the introduction. In other words, the previous section contains different ideas as authors want to provide the reader with an opportunity to keep track of the changing attitude to curative properties of cannabis and understand the background of the problem.
There is no doubt that the choice of appropriate research methods can be listed among the factors that define the success of a study. As for the methods used by the authors of the article, they have chosen a particular qualitative research design. In fact, the researchers searched the literature to conduct a thematic analysis which is known as a popular qualitative method.
The research design chosen by the authors is consistent with the purpose identified by them in previous sections of the discussed article. The use of thematic analysis can be seen as a proper method to generalize findings and identify themes related to patients’ experience.
I suppose that the authors have not introduced any bias in the procedures used as the decisions on whether to include certain articles in the sample were made based on the range of topics covered in the source and not on other factors that could be called subjective.
There is a range of sampling methods that can be used by researchers, and the particular method that the authors of the study preferred was purposive sampling. The authors did not define the exact number of studies to be reviewed before starting the work, but they singled out a range of requirements that chosen studies needed to meet. Thus, the studies needed to be published after 2000, present qualitative research, and touch upon only the medical uses of cannabis (not recreational).
The sampling method chosen seems to be appropriate as it enables the authors to fulfill their primary goal. As for the characteristics of the sample, the authors provide the information on the authors of the articles (countries where their experimented were conducted). Methods of sample selection provide a good representative sample based on the novelty of results and the topic. In general, the selection of the sample does not seem to be related to any biases. The sample size may seem to be inappropriate (there are five works), but, considering that the process of analyzing articles is time-consuming, there is enough information in these sources to cover the topic.
To collect the data, the researchers analyzed the articles based on specific criteria and used this knowledge to single out the basic themes. In the section related to study characteristics, the authors describe the tools and methods they were using, and the results of the preliminary analysis are presented in Table 1. As for possible limitations connected with the method of data collection, it can be supposed that including articles published before 2000 could give better results.
Having conducted the research, the authors have managed to conclude on the most common themes identified in the studies devoted to the medical use of cannabis for different purposes, including acute pain management in cancer patients. The qualitative data retrieved from the five sources used by the researchers was analyzed, systematized (see tables), and then the authors were able to single out the major themes emerging from the studies reviewed.
Even though methods used by the researchers are rather simple and the process can be understood by any reader who is aware of the qualitative research, one of the major weaknesses of the study is related to poor information concerning the analysis presented by the authors. Instead, they briefly describe the studies and then present the themes found in the course of the analysis. Describing the results, the authors include concrete examples that are linked to identified concepts. For instance, describing the theme presented by stigma, the researchers quote the participants to illustrate their experience. The examples presented in the section can be regarded as adequate because they demonstrate the attitude of the participants to their experience.
In general, the article does not contain the section that would be devoted only to the discussion of the results. Despite that, the elements of discussion can be noticed in six small sections before the conclusion. In these sections, the authors do not restate the purpose of their study and the research questions; they focus on presenting the results and providing more details to demonstrate that the analysis they have conducted is thoughtful.
Also, the authors clearly define the implications of the findings to nursing practice. There is the entire section devoted only to the practical significance of conclusions. Drawing the link between the findings and their possible implications, the authors also include particular facts on cannabinol to explain the way it is used in actual practice. At the same time, even though the researchers pay focused attention to describing the results and their implications, they do not identify potential limitations of the study, and this is why the article may seem to lack objectivity. The authors reflect on the topic of possible directions for further research, stating that the results of their study can help to analyze the topic of patients’ experience more thoroughly.
In the end, there are certain aspects of qualitative methods that I find challenging. In particular, I suppose that the use of information that cannot be checked (such as the personal experience) involves numerous risks for researchers, especially if they review the studies conducted by other authors. I suppose that only authors of original articles who have conducted interviews or used other qualitative methods can guarantee that the participants did not have any reason to tell lies while describing their experience. Also, during the work, a few weaknesses of the article were identified; the most important of them is that the authors do not present the information on limitations which makes the final section look one-sided.
Ryan, J., & Sharts-Hopko, N. (2017). The experiences of medical marijuana patients: A scoping review of the qualitative literature. Journal of Neuroscience Nursing, 49(3), 185-190. Web.