Article critique of a given journal


            The problem of focus in this paper is the need to protect young children from exposure to nicotine through smokers though they themselves are not smoking. This is because it has been known to be a major cause of respiratory illnesses. It has also been stated to be caused by contaminants that diffuse to the cigar paper, exhaled smoke and also through puffs emitted by smokers (Chan & Lam, 2006). It has also been shown that such smoke is found to be a co-carcinogen and increases the prevalence of carcinogenesis of the lung, bronchitis and pneumonia. This problem has also been seen to have increased incidences to children whose parents are smokers. This problem has been well stated with demographics being provided to ratify these claims; these demographics showed that majority of smokers were men, and most of their children had tendency to get associated diseases. The rationale of this study is to find out the effectiveness of education to mothers who have ill children with the aim to deter them from exposure. As supposed it is at the end of the introduction and clearly outlines the reason behind the study but does not give light to the consequences of study. Concepts that are crucial in this study are the significance of nursing in intervening where dire medical attention is required using clinical trials that are random and controlled. This paper has the hypothesis that there is a significance difference in intervention of nursing in managing sickness from cigarette smoke with that of no intervention answering the question of how significance the intervention is (Chan & Lam, 2006). This is however vague and can not be easily pointed out from an instance look at the paper but is derived from the results. The theoretical framework of this paper is wanting since though related directly to the thesis and having variables and construct it does not thoroughly analyze major concepts using certain social discipline theories except that of reasoned action that is long outdated since it is of 1967 (Chan & Lam, 2006) and does not clearly elucidate assumptions made which are must for any research paper and it is not up to date since it gives demographics of the ranging between the 90s an early 2000. The logic used is that their is an increase in diseases related to passive smoking and that they require to be addressed using nursing principles to reduce exposure and manage the diseases from getting worse. The literature review is not well organized since it should start generally then become specific as on  progress while for this case it’s the contrary since it starts with the cohorts of cigar smoke exposure, it does not clearly outline the themes of this paper since it focuses more on demographics but it consolidates previous research results concerning the topic. It is also not broad and has been merged with the introduction while they are supposed to be two different entities. However to some extent it is relevant to the study of this paper though not elaborative enough.


            This is a randomized controlled trial study and is effectively reliable for hierarchical scientific studies since it is effective in countering selection bias and can reduce spurious results that can not be easily analyzed. This is seen to have helped in effecting the inclusion criteria to select the participants of the study. It is also effective in this study since it helped to obtain information from human experiences thus enable the measuring of exposure consequences. It counters the errors of questionable extrapolation from experimental animals and uses questionnaires which can be referred to. It is however not the best method since it relies on observations and can not ascertain that the children in this case are suffering due to smoke exposure (Chan & Lam, 2006). The design is related to the sampling since samples using the questionnaires are collected from  persons of different backgrounds of Hong Kong but in the first collection of information is not randomized thus an anomaly with the reasoning to test the feasibility of the study. The descriptive results obtained from the design are then statistically analyzed using the chi square, t-test, F-test with the help SSPS version11.0. The sampling is not clearly described since we are only given the methods used for selection and the collection of the data but we are not given the details of the participants who full agreed to participate in the study. We are not also told about the participants’ details such as age groups; sex and also specific medical anomalies in question not until in the release of the results thus the details provided are insufficient. The justification for the sample is not given and the study protocol used is not concise since it only gives details of instructions to be followed, when but does not give demographics concerning the specific participants in every test. It is however efficient since it follows the principles of good clinical practices of confirming consent of participants and also testing the feasibility of the project. The main concept to be measured is any significant change for the health of children whose parents have been educated to prevent smoke exposure and those of controls which has been tackled well but much emphasizes have been put in preventing the smoking act other than avoiding of the child’s exposure to the smoke resulting to reduced consistent of the operations with the definitions given. The details of validity of the methodology used is not provided but external and internal validity are dealt with through randomization, frequent follow up through calls and questionnaires, measure of the outcomes but does not fully explain the characteristics of subjects and has no clear elucidation of patients characteristics. Consent of participants was sought and permission to withdraw at will was granted (Chan & Lam, 2006). There was no issue of concern about the ethics since they were approved by Hong Kong University though not by a recognized medical body. This procedure can be replicable only if more details concerning the participants, the use of the given values and the coherence of the procedure of selection, experiments done and data sampling are given unlike the current case of the article.


            Characteristics of the samples such as age, age groups, sex and complaints on health illnesses are provided. The research questions given are answered in different tables showing no significance difference between nursing education in intervened cases and those of controls based on different ages and medical complains. Research questions such children’ baselines, mother’s attitude towards smoking and passive smoking and also reactions to the father’s habit of smoking are also outlined crystal clearly. Tabular representation of the results has also been done as shown in the seven tables given. In the first table, it can supplement the text since it expounds on the details that a questionnaire will be provided during the data collection and is supposed to be answered, it also stipulates the guidelines that the nurse will give for intervened study providing information not in the text. In table two all the data is not included in the t-test though a valid reason is not given but the text helps to explain the information that is in the text in layman’s language though only concerning the complaints thus only a partial supplement of the table (Chan & Lam, 2006). Table 3 explains family characteristics and also the text explains the same and can be supplemented by the table. This case is however different for the other tables since they are more detailed compared to the text provided and are thus more elaborative. The nature of the data in every table determines the kind of data analysis tool to be used. Results of chi square, Fisher test and t-test which are descriptive analysis are outlined but this could result to inconsistencies in the data due to the different principles of each analytical tool though this was neutralized using the SSPS software. Graphical representation of the data however would have been effective in explaining the data since it is more practical and realistic.


The author relates the findings of the research to the thesis which aims at noting the difference in children who have received nursing education on how to reduce exposure from smoke so that it can deter diseases associated with it. Results have shown that the mothers were keen and gained education which they practiced reducing exposure though the fathers were less involved. The attitudes of the parents towards smoking also turned to a new turn on education though many of them were well aware of the implications that smoking resulted even prior the study (Chan & Lam, 2006). This study also focuses on opinions of other writers that the study of the parents was short lived and thus did not effectively take charge since it supposed to be of at least 12 months. However the discussion does not incorporate results and explanations concerning any similarity and difference of the results of this study and previous ones thus reducing its efficiency. The limitations given in this paper include disability to fully educate the parents of already discharged children after their period was due, contamination of information due to the busy environment of the study and it was too some extent not practical since most healthcare focus on treatment other than the preventive purpose of the study among others leading to reduced success of the study. The implications of these studies show a significant relationship between the exposure of children to smoke and the prevalence of respiratory diseases such as pneumonia and bronchitis. It also emphasizes the need to reduce illiteracy and ignorance so that the dangers that have been associated with smoke in harming children can be affected. Also it opens for future intensification of education concerning healthcare measures to prevent smoke exposure not only using nursing but a wide span of diseases such as cancer of the throat and esophageal. A new study concerning the response of persons to health education, effects of such educations and impacts it bring in the society are some many of the new studies taken up from this research but the potential of using nursing though known as an effective way to spread health education has reduced since it has not given any significance difference in this study. Though this may be evidently witnessed weakness of the methodology and procedures followed could have resulted to these results thus nursing can not be ruled out.

Overall presentation and final summary

The title accurately corresponds with the study though very long and gender biased since it focuses on women other than also focusing on men who were also participants of the study. The title also caters for variables in the study which are reduction of exposure of smoke to children, the change in attitude of mothers and also the interventions through nursing to educate parents (Chan & Lam, 2006). The target population of Hong Kong is also focused but not to more specific bases since the research is done in a hospital with persons of different backgrounds in terms of ethnic groupings and race. The report is logically consistent since it has the key aspects of a research paper which are introduction, methodologies and conclusion but lacks a comprehensive outlined literature review which is merged with introduction and also lacks a time plan. The writing style is quite legible but not consistent since different formats and font sizes are used making some portions to have limited legibility. The use of columns makes it difficult to read since the writing is much smaller.



Chan, S. & Lam, T. (2006). Issues and Innovations in Nursing Practice: Protecting sick children from exposure to passive smoking through mothers’ actions: a randomized controlled trial of a nursing intervention. Hong Kong: China, Blackwell Publishing Limited


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