Peppermint oil: A Treatment for Postoperative Nausea
TITLE: CRITIQUING A PUBLICATION OF AN EVALUATION APPLYING AN
EXPERIMENTAL OR A QUASI-EXPERIMENTAL DESIGN
Peppermint oil: A treatment for postoperative nausea. Journal of advanced nursing.
The present report is based on the experimental design study establishing the causal effect of peppermint oil in reducing nausea (Tate, 1997). This case is considered for the patient post-operation. Attempts have been made to critique this study against true experimental design. For this purpose, various things have been considered which include as to whether there is a clarity of purpose, who are the participants in the study, what is the nature of the intervention, what is the design of the intervention and control groups and which procedures are used to test the hypothesis. Lastly, suggestions have been made to improve the quasi-experimental design used in Tate’s (1997) study.
1.Is an experimental design the best way of establishing the causal effect of peppermint oil reducing nausea?
Experimental design is related to allocation of participants in different conditions during an experiment (Bowling and Bowling, 2002). In general, the participants are divided in two groups known as experimental group and control group. The change is introduced in the experimental group only. Further, there are three kinds of the experimental designs namely independent measures or between groups, repeated measures or within groups and matched pairs. In the first category of experimental design, the different participants are exposed in all the conditions of independent variable (Kypri,et.al., 2007). In the second category same participants have to take part in all the conditions of independent variable. And in the third category, in each condition different participants are used but they are matched according to the characteristics of age, gender etc. (Landorf, 2010). While using the experimental design for establishing the causal effect of the peppermint oil reducing nausea, the three conditional experimental design was used. The study used the statistical analysis for comparing groups. The Kruskal–Wallis test was performed for establishing the significance and the Mann–Whitney test was conducted to differentiate the significances between groups. The control, placebo as well as experimental groups of patients were compared and the perspective was postoperative nausea. In all the experiments, it was seen that when the peppermint oil was used in treatment, it resulted in better ways in controlling the nausea. The experimental design also examined the effectiveness of peppermint oil for the patients. The history is full of stories related to use of peppermint oil by ancient civilisations of the world. This fact forces the medical professionals to think once more and further establish that the Peppermint oil is able to decrease the level of medication in case of post-surgery patients. Thus, it can be said that the experimental design can be used in the best way of establishing the causal effect of peppermint oil in reducing post-operative nausea.
2. To what extent has this study adopted a true experimental design?
The study under the consideration has adopted the true concept of the experimental design in the following manner:
1. Clarity of Purpose
There is clarity of purpose for conducting this research. It has been found that the nausea occurs to maximum number of patients in their post-operative conditions. It causes uneasiness of patients and may hamper their recovery due to reluctance of medicine intake. Even after taking the medicine the patient remains in the stage of vomiting and effect of taking medicines related to his/her main disease (Aylward, et.al.,2010). To reduce the effect of nausea, the patient is required to take additional medicines. This study, aimed at whether the use of peppermint oil is effective in reducing the effect of the nausea in the post-operative patients, is conducted by the researcher to know whether the use of peppermint oil would provide additional benefits to the patients and the patients will be offered the more choices or not. The researcher wished to act on this research keeping in mind that the use of peppermint oil can be easily controlled by the patient themselves too and further because the peppermint oil offered the less side effects and can be easily used by the patients. It is cheaper than other medicines available for controlling the nausea. Thus, the researcher has direct clarity to purpose for which he used experimental design.
2. The Participants in the study
The study was conducted on the 18 patients who have undergone major gynaecological surgery. The participants were kept in one of the 3 groups (control, intervention, or placebo). The group 1 was the control group and the participants of this group received no treatment. The group 2 was called placebo and the participants of this group were given the peppermint essence. The group 3 was the experimental group and the participants of this group were given peppermint oil. Since the independent variable i.e. peppermint oil is volatile in nature, participants of all the three groups were kept in isolation for the purpose of preventing cross contamination. Thus, it is seen that the researcher has wisely conducted the test and selected the participants for the purpose of study. It is also to be borne in mind that the participants of the study were all women who are mostly affected due to nausea and the surgery for gynaecological disease put them much closer to the situations of nausea. The effect of peppermint oil can be easily gauged on the target patients in these circumstances. Thus, the selection of the participants in the study is quite suitable and it proves the suitability of the experimental design too.
3. The Nature of the Intervention
It has been found in the experiment that first of all the peppermint was subjected to analysis at an independent laboratory by the gas- liquid chromatography. The results were noted down. The participants of the experiment were compared according to their personal characteristics besides their past medical history as well as the prerogative anxiety levels. Due care was taken not to make any difference between the participants of the each group and each of the group was thus homogeneous in nature. It is the necessity of the every true experimental design and the same was observed here also. Further, the information in regard to anaesthetists, the surgeons, the surgical operation, medication as well as the fluid balance had also been gathered and the comparison of the data collected was done objectively. The due care was taken to make the group statistically similar. If considered about the individuals of the group, it can be said that there was only slight difference among the group members and the amount of the post-operative antiemetics that were given to them. The experimental group was given slightly less of the antiemetics. On the basis of previous assumption that there is a link between post-operative medicines for pain relief and the incidents of nausea; the pain relief medicines were also compared for each group. Thus, it is clear that right kind of intervention was approached for true experimental design.
4. The Design of the Intervention and Control Groups
It has also been seen that the participants who were kept in the control group were not given any peppermint oil in any form. This group was kept ideal as receiving no experimental drug i.e. peppermint oil. These persons were kept normal and isolated and the medication administered to them was carefully noted and the comparisons were done with the medication provided to the participants of the group of the placebo and experimental group. The studies were conducted on administration of opioids as well as the pain relief medicines too (Grix, 2002). Since the peppermint oil is volatile and there remains the possibility that getting the effects peppermint oil used by the participants of the placebo group or the experimental group, the participants of the control group were kept in isolation with other two groups of the study. Thus, the dependent variable of the control group can be said as the base group for the purpose of the study. The intervention done with this group is quite suitable for the purpose of the study and the data collected from the group can be said as the empirical data for the purpose of research. It can be said that the design of intervention of the control group is highly suitable for the experimental design.
5. The Procedures Used
As stated above, in the experiment three groups were formed and nil to moderate amount of peppermint oil was given to participants of the each group (Hesse-Biber, 2012). The first group was the control group and the patients of this group were given nil amount of the peppermint oil and they were kept in isolation to other two groups. The medication and activity of nausea suffering by the group members was studied. The second group was the placebo group and the members of this group were given only the essence of the peppermint oil. The medication received and the suffering of the group members due to nausea was recorded. The last group was called the experimental group and the members of this group were given the moderate level of the peppermint oil. The medication received and the cases of nausea were also studied for this group. The analysis of all the studies conducted and the data thus collected was done. The effect of nausea, the intake of peppermint oil and the medication received by members of the groups were recorded and the data was collected in terms of all these things. Care was taken to have the homogeneity of the groups and objectivity of the studies for making the experimental design suitable.
6. Controlling of Confounding Variables
It has been seen that the dependent variables i.e. the participants of the each group were considered to be homogeneous but they were kept in isolation only with the view to avoid the effect of the peppermint oil on those persons who were not intended to be given the peppermint oil. Had this not been done, the basic purpose of carrying out the research would have been defeated. The confounding variable has been effectively controlled to have the real effect of use of peppermint oil on outcome. The researcher has successfully controlled it. The technique used for preventing or controlling the confounding variable is the randomization. This means that no bias is caused in selection of the members of the group and among the group itself. All the groups are homogeneous and no difference is apparent due to any reason.
7. Interpretations based on evidence
It has been found that the nausea is generally associated with the anaesthesia but the severity of nausea in a patient depends on various factors. It is also difficult to accurately measure of the nausea and it can be said as the internal disease and can be known by the other person only when it is expressed by the sufferer. It has also been seen that the severity of nausea depends of various factors such as gender, age, phases of menstrual cycle, past medical history of the patient, post –operative pain and its intensity, intake of medicines etc. Though, there are various kinds of drugs available to treat the nausea suffered by the post-operative patient but all the drugs have not shown the correct effect. The research was able to reflect that the peppermint oil is capable of antagonising the sensory receptors that are involved in emesis. The present research has proved that the peppermint oil is effective in controlling the post-operative nausea. All these have made the true experimental design in the present context.
3.What suggestions would you make to improve this experimental design?
The following suggestions can be made to improve the experimental design:
(i). The research team involved in carrying out the experiment should have the experimental mindset and it should start with the hypothesis and should not assume the facts (Victora, Habicht and Bryce, 2004). It is also necessary to add here that the researcher should remove all sorts of bias that may have arisen in his mind.
(ii). The research team should concentrate on the specific assumptions and should not add their own ideas. The ideas should not be tested, rather the assumptions should be tested. It is because, if the researcher is embedding his own ideas into the research, the outcomes will be affected badly and the basic purpose of carrying out research is defeated (Jolley, et. al., 2007).
(iii). The questions for the research should be framed on “compare and contrast” models. The experiment should look at broader aspects. The narrower aspect of the researcher will not let him making right decision and in the right directions and hence it should be avoided at all the levels (Orr, 2018).
(iv). The assumptions should be kept in hypothesis format and each of the assumptions related to the experiment must be tested (Donaldson, Gooler, and Scriven, 2002). This avoids the building of wrong capabilities and thus addition of wrong data in the research.
(v). The experimental design should be aligned before starting of the experiments. It means that all the minute details of the experimental design should be considered and taken in to account (Mayne, 2008). If the research is carried out by the team, each and every member of the team should be aware of all the details of the research in-hand. This will avoid all the ambiguity and improves the co-ordination among the team members engaged in the research.
(vi). Sufficient time should be devoted in getting the right kind of experimental design (Ziviani, et.al., 2011). The team should be specific to test the assumption. This is possible only when each and every member has the idea as to direction in which they have to proceed, the data to targeted and other various details.
(vii). The experiment stimulus and the data that is planned to collected should be specifically designed. This is again depends on the right level of coordination among the team members.
(viii). The participant of the experiment should be specifically decided as defined. For example, in the present experiment the participants were post-operative persons and all of them have undergone surgeries of the gynaecological disease.
(ix). The researcher should have the clear rationale for the experiment design/data collection. The over-testing should be avoided. He should have a strong theory for moving his metric.
(x). The upfront decision should be made for the process of data analysis. The clear directions should be made as how to proceed when the data is supporting the assumption and what will be the reaction when the assumption is refuted by the data.
(xi). The researcher should not hesitate to reconfirm the findings arrived at by him. This can be done by the "RE-search" or “Repetition”. It can be said that with the help of repetition, the sample size is bound to increase and the experimental design will have the data more accurate (Kinmonth, et., al., 2008).
(xii). The researcher should also exercise control in terms of the measured variables used in the experiment (Values, 2003). This helps in producing the sound data and making the experimental design more objective.
This article established the result of peppermint oil usage in postoperative nausea. The report also considered the confounding variables and made the interpretations on the basis of the evidence. Some suggestions have been made to improve the qualities of the experimental design.