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ACritique of the Article &quotPain-Related Factors Associated withLost Work Days in Nurses with Low Back Pain: A Cross-SectionalStudy.&quot

Descriptionof the Article

Thepaper Pain-RelatedFactors Associated with Lost Work Days in Nurses with Low Back Pain:A Cross-Sectional Studyis a research article that attempts to explain low back pain as acause of disability and lost work days. The article was written bySaurabSharmaa, Nischal Shresthab, and Mark P. Jensen. Like other researchpapers, this article contains the proper format used in writingresearch papers. Its body is made of a title, an introduction,methods, results, discussion, conclusion, implications, andreferences.

Thetitle is precise and mentions what is to be covered in the article.It is catchy and makes one want to know more about the article. It,however, fails to define the study population making it hard for thereader to identify the study area. The study area and a deeperdescription of the population have however been covered in themethods area. The abstract on the other hand has been developed in aconvenient manner as it indicates to the reader all that they shouldexpect from the article. The researchers used the introduction togive the relevant background for the problem and justify themselvesby explaining why the problem had to be studied.

Theresearch problem, as described by the researchers, is of greatsignificance in the current study area. The researchers have alsoindicated their predictions in the introduction and have even goneahead to give the reader an insight of the study area. By reading theintroduction alone, one can easily see the great depth ofunderstanding that the researchers have regarding the problem theychose to study.

Themethodology section was properly developed as it clearly describesthe processes used in carrying out the research. The informationcontained in the method section is sufficient and therefore indicatesthe soundness of the research process. From the article, it is clearthat eighty-seven percent of the nurse’s population took part inthe study. Such a number is sufficient in creating a proper samplefor the cross-sectional study.

QuantitativeCritique of the Article


Thisis a critical section of any article as it should describe the wholearticle in a precise manner. In this particular article, the titlePain-RelatedFactors Associated with Lost Work Days in Nurses with Low Back Pain:A Cross-Sectional Study isspecific and clearly states what is to be covered in the article. Thetitle clearly outlines the variables for the research. It is alsothrough the title that one can first tell that the study was based onnurses thus giving an aspect of the study population.

Thetitle, however, fails to outline the location where the study wasconducted. An inclusion of the study location in the title would havebeen an excellent step as the reader would be able to know where thestudy was carried out by reading the title. An indication of the typeof study on the title was commendable as one would clearly know fromthe title the study is a cross-sectional one. Due to the precision,the ability to outline what one should expect from the article, andthe correct placement of the variable in the study, the title of thearticle was well enunciated.


Theabstract of the article clearly outlines all the essential elementsof the article’s body. From the abstract one can clearly get apicture of what the article is about, the research being carried outand the method in which the research was conducted, the results ofthe research, conclusion and the implications of the research. Theresearchers made the abstract very succinct and straight to thepoint. From the abstract, one can clearly tell what the aim of theresearch was, and a brief background of the research. Such servesright as it prepares the reader on what to expect in the othersections of the article. Another important thing that the researchersdid was to brief the reader on the methodology, where the type ofstudy and sample population have been indicated.

Fromthe abstract, one can unmistakably point out the research problem.The researchers were keen to include the research problem in theabstract which acts as a guide for the reader as they will alwayswant to identify whether the research problem was solved or not, andif solved, in what ways.


Inthe introduction section of the article, the researchers have statedthe research problem but in an unclear manner. The problem has notbeen stated as a question, but through the introductory words, thereader can tell what the study indicated in the article was purposedfor. The article’s introduction section has failed to distinctivelyshow the reader the various parts that should be in the introductionsection. It, therefore, requires great understanding and knowledge ofwhat sections such as rationale should entail for one to note thatsuch has been included in the introduction.

Theproblem statement creates a lucid, persuasive argument for a newstudy. The article clearly indicates that the nurses are highlyaffected by low back pains due to the nature of their work (Sharma etal., 2016). It also states that the low back pain is a majorcontributing factor to disability and that the nurses are highlyaffected. With such cogent statements, together with the prevalencerange of the condition that is stated to be between sixty-one andeighty-four percent of the nurses worldwide, the article’s argumentcalls for a new study into the problem.

Theproblem that the research is trying to solve as indicated in theproblem statement is of great significance to the nursing field. Thearticle states clearly that the problem is highly prevalent among thenurses. Also, the article goes ahead to mention the factors such asbending and twisting, which predisposes one to the condition beingstudied and such factors are also experienced by the nurses (Sharmaet al., 2016).

Theresearch problem matches well with the methods and the standards usedin the research. On the same regard, the research takes aquantitative approach in trying to solve the stated problem. Theintroduction mentions a predicted incidence of the problem among thepopulation to be studied. It also refers to a previous researchconducted on the same population and this, in some way, justifies themethods used in the research article. The methods used, especiallythe quantitative approach is excellent in assessing the incidence oflow back pains within the population of study, which was the aim ofthe study as stated in the article. Again, the introduction sectionof the article has been well put and justifies the appropriateness ofthe methods applied in carrying out the research.

Thearticle lacks a distinct and elaborate research question. Failure toinclude a clear research question makes it hard for the reader tocomprehend what the research article aims to answer. A researchquestion needs to be well put so as to guide the reader on theobjective of the research and also to connect the conclusion with theentire body of the article.


Thehypothesis of the research has been included in the article thoughnot stated in a clear and distinct manner. The claim has been put ina general way and one that might be hard to note. The authors of thearticle ought to have directed the reader by stating clearly thelocation of the hypothesis so as not to give the reader a hard tasktrying to locate it within the lines of the introduction. Thehypothesis, however, contains the relevant variables and attempts todefine the study population by grouping them into three sets based onthe level and characteristic of pain that they experience. Thearticle bases its hypothesis on knowledge from previous findings andthe study of the population of nurses. An elaborative and intensivereview of literature is, however, missing in this article. Thearticle only mentions, in the introduction section, what the authorknows about the low back pain condition and its association withnurses, but fails to include citations to indicate the literaturefrom which the information was derived.

TheLiterature Review

Thearticle has failed to include an intricate literature review. Infact, the article has no section for the literature review. Also,there are no citations in the text to link one to the sources ofinformation contained in the report. Failure to set a separatesection for the literature review hinders a thorough evaluation ofthe literature. The literature review in the introduction section isvery brief and fails to give credit to those who laid the groundworkfor the research.

Anelaborate literature review makes the reader see researcher’sunderstanding of the theoretical and research issues that are relatedto the research problem stated. By failing to provide an extensivereview of the literature, it is hard to tell of the researchers’ability to evaluate the relevant literature information analytically.Also, by failing to provide the sources of the text, it is hard totell the age of the literature from which some of the information wasretrieved, hence hard to determine whether the literature review isup to date. The brief literature review contained in theintroduction, however, manages to provide evidence for the existenceof the problem. It even goes ahead to offer some statistical data onthe same. With the evidence and some information contained in theshallow review, the article succeeds in providing a base for a newstudy.


Thepaper’s author has tried to develop a theoretical framework for theresearch. The author has based some of the theories on findings fromother studies and probably the literature of other people.Nevertheless, the article fails to include in-text citations, thus,failing to acknowledge the sources of such information.

Thekey ideas of the research have been put in the correct manner andadequate definitions of the same included. One such instance wherethe article has correctly tried to prove its theory is when theresearchers explain how the low back pain condition and itsprevalence among the nurses relate. In such a case, the researcherslinked the low back pain among the nurses to the state of their workand the activities that they indulge their bodies to while performingtheir duties. Such an explanation supports their theory and thusjustifies the theoretical framework.


Protectionof Human Rights

Asevident from the article, the research was carried out in the rightmanner following the proper procedures to ensure that the rights ofthe participants are not infringed. The consent served to theparticipants of the study was an excellent means of ensuring that thenurses who take part in the research do so out of free will. It canalso act as an evidence of the same. The article also suggests thatthe participants were given time to fill the consent forms. Thus,this makes it evident that the decision made by the participants totake part in the research was made out of free will and that theytook their time to understand the benefits and consequences ofparticipating in the research.

Itis also evident from the article that an external review committeeapproved the study. The article mentions that the research has beenendorsed by the Institutional Review Committee of KathmanduUniversity School of Medical Sciences and Dhulikhel Hospital inNepal. Such is an important step as it ensures that the participants’right are assured, safeguarded, and followed throughout theirinvolvement in the study.


Thestudy design used for the research is a cross-sectional one, and itserves right for this type of the investigation. The study majorsmostly on the prevalence of the low back pain thus making thecross-sectional design more suitable for the study as it entails asnapshot in time (Lin, Chen &amp Huang, 2012). Different steps weretaken by the researchers to ensure that the findings are easilyinterpreted. One such step in the data collection process was the useof the standard Numerical Rating Scale to capture the intensity andseverity of pain as felt by the participants. The use of such a scalewas beneficial in ensuring that the process of interpretation of thefindings is smooth and efficient.

Inthe study, the data was collected from nurses in one hospital. Thetitle, however, failed to specify the location from which the datawould be collected, and this would, therefore, make one conclude thatthe findings represent the population of nurses around the globe. Inthe real case, the methodology section of the article mentions thatthe research was conducted at Dhulikhel Hospital in Nepal. The use ofa single location for the collection of data of such research was notappropriate as the findings would only be based on this place. Also,factors such as the workload of the hospital regarding patientpopulation at any given time could have been considered as this mayhave an effect on the findings, and may vary between hospitals. Thefact that the research was conducted in one hospital creates higherchances of bias. The study also failed to consider different factors,therefore, making it unsuitable to represent an entire population ofnurses.

Populationand Sample

Thearticle covered this section in an appropriate manner. The studypopulation has also been described in an efficient manner. Detailssuch as the demographic information, work history, number of workinghours, and the work setting have explicitly been mentioned andconsidered in the research. The paper, however, fails to mention themethod used in determining the sample for the research. With suchexclusion, it is hard for one to measure or ascertain the level ofbias. The sample population of eighty-seven percent of the totalpopulation of nurses in the hospital was sufficient for the research,especially in that particular setting. The article, however, failedto indicate whether there was a power analysis for the estimation ofthe sample size needs.

DataCollection and Measurements

Thearticle clearly outlines the key variables which are operational andtheir use have clearly been justified. Pain as one variable used inthe study has been elaborated in an extensive manner. With properevidence, the Numerical Rating Scales have been justified as the besttool for the collection of data as suggested by Sharma et al. (2016).The article failed to provide evidence of the efficiency of the datacollection methods and the validity of the data received.



Theresearchers were keen to conduct an analysis for testing eachhypothesis and therefore creating a platform for testing them againstthe results to be obtained. They employed the use of t-testsfor categorical predictors and Pearson’s correlation coefficient.These are suitable for the particular variables they were used totest. The analytic tool used served a purposeful function incontrolling the confounding variables. The analytic tool used forcontrolling the confounding variables was the Statistical Package forSocial Sciences (SPSS), which the researchers employed in analyzingthe data on pain. Nonetheless, the analysis area of the articlefailed to indicate the presence of errors and how the same weresolved. It is, therefore, unclear to note whether type one or twoerrors were available or there were steps taken to avoid theiroccurrence in the research. The paper does not indicate the presenceof any missing values.


Theinformation regarding the statistical significance is missing in thearticle. Also, there is no information relating to the effect of sizeand precision of estimates. The findings, however, indicate that allthe participants in the research happened to be females. The resultshave also been reported in a form that expedites meta-analysis.Tables were used to summarize the finding of the study and such givesthe reader an easy time when checking the results. The informationcontained in the tables and texts of the findings bares enoughinformation required for evidence-based practice.



Theinterpretation of the findings of the study has been conducted in anostentatious manner in the discussion area. The findings linkcorrectly with the knowledge contained in the literature review. Thediscussion has gone a long way to prove the theoretical framework tobe right. The interpretations have been well stated and are solidlybased on the findings of the research together with the availableliterature as cited in the text. Such interpretations make it easierfor the reader to tell of the researches success in trying to find ananswer to the research problem. The report does not address the issueof generalizability of the findings.


Thearticle states the clinical implications of the study in a clearmanner. The researchers acknowledge that the lower back pain is acommon condition among the nurses worldwide and that more has to bedone to reduce the prevalence of the condition. They go even furtherto recommend what needs to be done in case a nurse develops a lowerback pain. The researchers also state that extensive research intothe condition is necessary.



Theresearch report has been well organized, but the introduction hasbeen put in a very general format. A subdivision of the introductorypart into sections that distinctively indicate the hypothesis,problem statement, research problem and the objectives would havemade the report clearer and easy to comprehend. The researchers alsofailed to put the literature review in its section but insteadincluded it in the introduction. Such limits the extent in which theliterature is reviewed leading to a less thorough review of theliterature. However, the report has been written in a form that makesit easy for the nurses to access the findings.


Throughoutthe report, the researchers have portrayed a high level of competencein trying to solve the problem. Such expertise is seen especially inthe methodology, results and the discussion area. Such credibilityenhances confidence in the research findings and the interpretationof the findings, as suggested by Polit and Beck (2012).


Theresults of the research appear to be valid and one that can betrusted. Such is guaranteed by the process employed in collectionsand analysis of data. The report also offers persuasive evidence thatcan be applied in the nursing practice especially when attempting tocombat lower back pains by taking precautions.


Sharma,S., Shrestha, N., &amp Jensen, M. P. (2016). Pain-related factorsassociated with lost work days in nurses with low back pain: Across-sectional study. ScandinavianJournal of Pain,11,36-41. doi:10.1016/j.sjpain.2015.11.007

Lin,P., Tsai, Y., Chen, W., &amp Huang, S. (2012). Prevalence,characteristics, and work-related risk factors of low back pain amonghospital nurses in Taiwan: A cross-sectional survey. InternationalJournal of Occupational Medicine and Environmental Health,25(1).doi:10.2478/s13382-012-0008-8

Polit,D. F., &amp Beck, C. T. (2012). Nursingresearch: Generating and assessing evidence for nursing practice.Philadelphia: Wolters Kluwer Health/Lippincott Williams &ampWilkins.


Sharma,S., Shrestha, N., &amp Jensen, M. P. (2016). Pain-related factorsassociated with lost work days in nurses with low back pain: Across-sectional study. ScandinavianJournal of Pain,11,36-41. doi:10.1016/j.sjpain.2015.11.007

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