A Critical Realist Review

Rationale for Method and Analysis

A critical realist review outlined by Edgley et al. (2014) which aims to extensively research the literature and critically evaluate its quality will be used for this proposal. The research seeks to address the difficulties that members of a multi-disciplinary team and more specifically psychiatric nurses face when communicating a diagnosis of dementia to their patients, including how they should respond to the issue raised. The rationale is that although there is extensive literature available on communicating a diagnosis from psychological and medical disciplines (e.g. Downs et al. 2002; Holroyd et al 2002; Milby & Murphy, 2013; Murphy & Gair, 2013; Pinner & Bouman, 2003; Pratt & Wilkinson, 2003; Smith

However, as Pawson et al. (2005) has highlighted the process of quality assurance is more dependent on explicitness and reflexivity on the part of the person undertaking the review. In retrospect, I have acknowledged these points as far to say that my previous work experience as an assistant psychologist in a memory clinic has created a negative bias towards neuro-psychological assessment and diagnosis for patients with dementia. Since this bias is one of the reasons why Pawson (2006) has argued for the transparency of evidence and the use of logic to ensure the author knows the basis on which inferences are made, a critical review used in this instance will ensure that the I use a broad range of research evidence from the literature to formulate arguments. This approach will then aid in formulating opinions, theories and, at best, tentative recommendations (Grant & Booth, 2009) for nursing practice. According to Pawson et al. (2005) this will help to minimise research bias whilst ensuring research is carried out to the highest methodological standards. However, as he has highlighted in his paper under the section of the strengths and limitations of a critical review, the quality of review in its self will be wholly dependent on my level

Through these principles and the use of a critical realist lens the review hopes to analyse both quantitative and qualitative data across conventional boundaries of medical, nursing, psychological and healthcare research within a realist ontology (Jennings, 2006). By enhancing evaluation in this way it is hoped that this will then lead to the formation of a new conceptual framework or theory (Danermark et al. 1997) that can then be used to improve the effectiveness and/or the efficiency of interventions (Jennings, 2006) within nursing practice. The review is critical in the sense that it is specifically targeted at forms of social interaction and social justice, of which social and clinical practice interventions are part (Eadgly, 2014). It is also critical not just in the sense of settling empirical disputes in the literature, but critical in the broader sense of using theories to adopt an unbiased ‘normative’ position on an issue under consideration (Eadgly, 2014). Similar to a systematic review the ultimate intended outcome is that research findings and analysis would be used to help practitioners in the field (Jesson & Lacey 2006). It is hoped that through the dissemination and implementation of conclusive points of reference in the paper that