How to write a nursing Critical Appraisal of Qualitative studies

How to write a nursing Critical Appraisal of Qualitative studies

Introduction: Diabetes mellitus is a chronic metabolic disease that occurs due to insulin resistance, insulin deficiency, or both. “The number of individuals suffering from diabetes Mellitus is expected to rise from 463 million in 2019 to 700 million in 2045” (Qasim et al., 2022). A diabetic ulcer is the main complication of diabetes. This paper will critically appraise two qualitative research on diabetic ulcer care. Additionally, the paper will demonstrate the application of ethical considerations in each research study.

Background of the study

The first research topic is “Attitude and knowledge about foot care among diabetic patients in Riyadh, Saudi Arabia” (Alshammari et al., 2022). The objective was to “determine the knowledge, attitude, and practice to diabetic foot care among patients attending a diabetic clinic in Riyadh, Saudi Arabia.”  The researchers used a descriptive cross-sectional study and structured questionnaire on attitude, knowledge, and practice to collect data (Alshammari et al., 2022). The research question was “does knowledge, attitude, and practice influence diabetic foot care?”.

The second research is “Research of knowledge and attitudes of patients with diabetic foot ulcer regarding foot care” (Qasim et al., 2022). The objective of the study was to “analyze the diabetic foot ulcer patient’s knowledge and attitudes regarding foot care” (Qasim et al., 2022). The researchers used a simple random sampling method, face-to-face interview, and a survey form to collect data (Qasim et al., 2022). The research question was “what is the knowledge and attitudes regarding foot care?”.

 PICOT Question

My picot question is; In diabetic patients, how effective is daily foot skin temperature monitoring compared to therapeutic footwear in preventing recurrent foot ulcers during and after admission.

The two studies demonstrate how the knowledge and attitude on diabetes management influence diabetic ulcer care. The findings indicate the majority of the patients don’t have sufficient knowledge of diabetic ulcer care (Qasim et al., 2022). Also, some patients demonstrated negative attitudes on carrying out some practices in diabetic ulcer management.

The purpose of each research was to assess the knowledge and attitude of diabetic patients in ulcer care. This is applicable in my PICOT question because it demonstrates how knowledge in interventions and practices influence ulcer care. Both foot skin temperature monitoring and therapeutic footwear are techniques for ulcer management, but how does the knowledge in both interventions influence the management of the diabetic ulcer? They both answer my PICOT question. Furthermore, both the studies and my PICOT question demonstrate how the knowledge of techniques influences diabetic ulcer care.

Methods of study

Survey as a methodology in research entails collecting, analyzing, and interpreting data of phenomena or individuals by asking questions. In the first study, the researchers used a descriptive cross-sectional study design, while in the second, they used survey forms to collect data. Under descriptive cross-sectional study design, the researchers gather information on the variables without manipulation; they just observe and measure (McCompes, 2022).

The advantage of using descriptive cross-sectional design in qualitative research is that it can be used to prove or disapprove assumptions at a specific point in time. The main limitation of the descriptive cross-sectional design is that it cannot explain or analyze behavior over a while (McCompes, 2022. For a survey, a broad range of data can be collected from a large number of respondents. The major limitation of the survey is respondents might be uncomfortable providing responses that are presented unfavorably.

Results of the study

The first study demonstrated a high number of diabetic patients with deep knowledge and a better understanding of diabetic ulcer care with the corresponding negative attitude toward footcare (Alshammari et al., 2022). The study indicated the need for awareness programs to educate and improve knowledge and practice for managing diabetic ulcers (Alshammari et al., 2022). Also, there was a need to encourage patients to have a positive attitude towards diabetic ulcer care. Only a few patients received education on diabetic wound care.

In the second study, it was determined that most diabetic patients don’t receive sufficient education on diabetes ulcer care (Qasim et al., 2022). Also, most patients demonstrated a negative attitude towards practices used in managing pressure ulcers. The research demonstrated the need for training diabetic patients on managing diabetic ulcer sores to foster self-care abilities and positive behavior change (Qasim et al., 2022). Likewise, nurses motivate and strengthen patients’ attitudes in carrying out practices necessary in managing foot ulcers. This will reduce possible complications and improve the quality of life for those suffering from diabetes ulcers.

Implications of research studies in nursing practice

The two studies have exposed gaps in the managing diabetic foot ulcers. The gaps are knowledge deficit and negative attitudes toward practices applicable in managing diabetic footsore. These findings have contributed positively to the nursing practice; the health care providers can address issues when managing diabetic ulcers, which in turn will improve the quality of care and patient outcomes. Additionally, it has provided a base for further research studies on the topic.

Ethical considerations in research

During research studies, the respondents should only be involved after taking informed consent (Bryman & Bell, 2022). The researcher should serve participants with sufficient information on the research topic. Also, the participants should understand the implications of participating in the research process and decide whether or not to participate without coercion (Bryman & Bell, 2022). Likewise, participation is voluntary, and participants have the right to continue or withdraw from the research at any stage or time.

In any research process, privacy and confidentiality of participants’ information are mandatory (Bryman & Bell, 2022). The researcher should take precautions and make sure any information linked to the respondents is safe and can’t reach unauthorized personnel. It should only be used for research on not any other use.

In the first study, the research was approved by Institutional Review Board [IRBNo.H1RE-01-Aug18-01] of King Saud Medical City before conducting the study” (Alshammari et al., 2022.  Additionally, respondents’ informed consent was taken before starting the research process and collecting data using a questionnaire.

In the second study, the researchers obtained permission from the Clinical Research Ethics Committee (No: 2017-52635). The researchers obtained both verbal and written consent of the respondents after clarifying the study (Qasim et al., 2022. Lastly, the researchers protected participants from reaching unauthorized personnel, and it was only used for research purposes.



Both studies determined how knowledge deficit and negative attitude toward practices negatively affect diabetic foot care. There is a need to educate and train diabetic patients on wound management Alshammari et al., 2022. Likewise, the studies found the importance of a positive attitude toward the practices by the healthcare providers, especially nurses.


Alshammari, Z., Alsaid, L., Parameaswari, P., & Alzahrani, A. (2022). Attitude and knowledge about foot care among diabetic patients in Riyadh, Saudi Arabia. Retrieved 11 January 2022, from.

Bryman, A., & Bell, E. (2022). Ethical Considerations – Research Methodology. Research-Methodology. Retrieved 11 January 2022, from

McCompes, S. (2022). Descriptive research. Scribbr. Retrieved 11 January 2022, from

Qasim, M., Rashid, M., Islam, H., Amjad, D., & Ehsan, S. (2022). Knowledge, attitude, and practice of diabetic patients regarding foot care: Experience from a single tertiary care outpatient clinic. Retrieved 11 January 2022, from.

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