Chapter III Methodology and Methods : Quality of Life: Comparison Between Hemodialysis and Continuous Ambulatory Peritoneal Dialysis

Chapter III Methodology and Methods :

Quality of Life:

Comparison Between Hemodialysis and Continuous Ambulatory Peritoneal Dialysis

(1500 Words)

Chapter III Methodology and Methods



A literature review is a very significant aspect in the process of research since a lot of literature reviews provides evidence and support for a point of view, argument and thesis. Other literatures were written as a background for different reports; like some articles convincing the readers in accepting changes in practice, other articles states a concept or strategy for readers or researchers to fully understand the topic.

Series of literature were obtained through different electronic databases such as MEDLINE, CINAHL and EMBASE. Using the keywords “Quality of Life”, Continuous Ambulatory Peritoneal Dialysis (CAPD)”, and “Hemodialysis (HD)”.Since dialysis is a very special process, it is also significant to search for various journals, such as “Journal of American Nephrology”, “Journal of American Nurses’ Association” and “Hong Kong Journal of Nephrology”. This electronic search yielded a total of over 50 articles. Then articles were read, and some of the articles were not included because of low response rates; some articles discussed entirely one of the treatments; some use the same assessment tools and many more. The article that were chosen have surveys using different instrumental tools, sample sizes, genders, age groups, populations, duration of study, that would be an important factor in developing a dynamic knowledge base to carry out the research or survey of future papers.


A literature review according to Beanland et al[1] (1999) is a “broad, scholarly, comprehensive, in-depth, systematic and critical review of scholarly publications, unpublished scholarly print material, audiovisual material and personal communication”. The main purpose of a literature review is to impart the readers the ideas, information and knowledge that has been already authenticated regarding the chosen topic. The review of related literature must be guided by a general idea; it must also include the strengths and weaknesses of the topic.


The reviewer of the related literature must be conscious enough to use topics that are accepted and valid. All research uses and provides literature reviews, even though the objective for accrediting the related literature varies according to the methods that a particular study is based on. Richardson[2] (2000) discussed that a literature review supports the content and significance of the study. It is mostly at the beginning of the thesis. For the most of the methodologies the related literature places the study in a particular context by relating it to other researches, confirming and challenging the outcomes and presenting new thoughts.


Employing important literatures allows the author of the study to persuade its readers that the purpose, the procedure and the end result of the study is well supported by the present knowledge.


Critique the ten articles


Ten articles were chosen from over fifty yielded from different electronic database. The articles were related to the chosen topic. By using the ten articles information were obtained and generate a balanced examination on former literatures. The Critiquing Framework by Bray and Ree[3] (1995) was used in the ten articles. The framework uses twelve questions in checking the article. This framework is very simple and convenient. It lets the researcher identify the direction of the chosen articles.




Search strategy


Search strategy’s purpose is to find citations defined as meta-analyses, clinical trial reviews, evidence-based medicine, and consensus development conferences, citations from articles and journals and systematic reviews. The first step is identifying the research topic by posing a question. After the identification of the topic search up using the keywords on encyclopedias, articles in the library and medical journals. Outline the topic and note important bibliographies and references. This search objective is to identify the background, clinical trials and literature reviews that give a comprehensive view on the quality of life in Continuous Ambulatory Peritoneal Dialysis and Hemodialysis patients.


Preliminary literature review


There are a lot of ways in considering for a topic in a dissertation, some students opted to talk to their professor, and in my case health professionals related to my field of study. Talking to a person who has a great knowledge on your topic makes it easier to create a topic for dissertation. The persons superior to you have extensive information regarding a lot of topics which in my case is health related. Aside from talking to health professionals and professors, talking to your classmates and friends is also a good way in considering a topic for dissertation. They can give and suggest different topics that you may want to create a dissertation. Observe around your surroundings, sometimes things that you do not notice gives relevant questions that can be considered in a dissertation. Watch television and read books being up-to-date on the latest illnesses and outbreaks might also be an advantage. In looking for a topic or an idea for dissertation every one of us must be receptive to new and different ideas.


Electronic databases search


Internet is the new source of researches, different online libraries such as MEDLINE (Medical Literature Online) provides up to date researches and studies which is very useful in the dissertation. Using the electronic libraries in the university or hospital is another choice because it can be easily accessed and it’s organized therefore making it a lot easier to find journals related to your topic. Hospital libraries have CD-ROMS that have topics that are worthwhile. It is also an efficient way in scanning through a lot of the references. You won’t encounter the hassle of opening a lot of books. Using search engines like Google and Mywebsearch is also used in finding on line journals. Search terms that I used included: Quality of life, Continuous Ambulatory Peritoneal Dialysis (CAPD), Hemodialysis and Peritoneal Dialysis.


Primary and secondary sources


According to Polit et al[4](2001) primary sources came from conceptual


literature that were written by the people who developed the theory, it is usually published in journals and books. A secondary review on the other hand is a summary of the works of other authors. The most important pieces of information can be found in different research a report, which gives a summary on the most interesting parts of the investigation, it usually follows a particular style, which constitutes different primary resources. Primary resources are usually preferred in making a literature reviews because secondary sources might have a different interpretation regarding the particular topic.


I used ten articles; ten of those are primary resources which include: (1) Suicide as an indicator of Quality of Life: Evidence from Dialysis Patients by Ford Ford and Kaserman 2000 (2) Hemodialysis and Peritoneal Dialysis: Comparison of Adjusted Mortality Rates According to the Duration of Dialysis: Analysis of the Netherlands Cooperative Study on the Adequacy of Dialysis 2 by Termorshuizen 2003 (3) The experience with Continuous Ambulatory Peritoneal Dialysis in Moscow by Tomilina et al (2000) (4) The Effects of Body Size and Body Composition on Survival in Hemodialysis Patients by Beddhu et al 2003 (5) Comparison of Mortality between Patients Treated with Hemodialysis and Peritoneal Dialysis by Bloembergen et al 1995 (6) Comparison of Continuous Ambulatory Peritoneal Dialysis and Hemodialysis Patients Survival with Evaluation of Trends during the 1980s by Nelson et al 1992. (7) Analysis of Depression in Continuous Ambulatory Peritoneal Dialysis Patients by Jung et al 2002. And (8) Survival Comparison between Hemodialyis and Peritoneal Dialysis based on Matched Doses of Delivered Therapy by Churchill et al (2002)


The secondary sources included: (1) Peritoneal Dialysis compared with Hemodialysis in the treatment of end-stage renal disease by Alloati et al (2000) and (2) Peritoneal Dialysis in Europe: An Analysis of its Rise and fall by Lameire et al 2006.


In selecting those articles an inclusion criteria was made based on the following: (1) Studies published within the period of 1992 up to the present. (2) An analysis on patients undergoing Peritoneal Dialysis and Hemodialysis. (3) The Quality of life of renal patients using either of the two treatment modalities


Ethical issues


The principle on the ethical context according to Polit et al (1999) includes beneficence, respect in human dignity and justice. In beneficence, the patients must be protected from physical and psychological damage during the period of the research. If the patients were harmed or acquired stress due to the investigation, the study would be automatically terminated and excluded. For that reason the sample patients gathered by the researchers have consent from the patients and did not cause any harm to patients well as the family members.


Recording and organizing from references


Recording and organizing the reference must be done right after you gathered the data and pieces of information you need in making a dissertation. In this way, relevant research studies can be identified and be separated from irrelevant ones. After separating relevant from irrelevant studies, the relevant studies must be organized according to the relation to your topic. Prioritize the topic that would be a big help in the literature review. Use markers in highlighting important phrases to avoid getting lost while reading. It can also make it easier for you to find the important parts of the study if you are rereading the journal articles and researches. After gathering the information, data, and references a very important part of a literature review is organizing the references. Since most of my references came from electronic database I had it print out and made highlights on important parts of the study.