Patients Failing to Adhere to Medications on ART Therapy

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SECTION I INTRODUCTION
* What is the research problem and is it clearly stated in the paper?
The area of concern for the research in question was that patients often fail to adhere to medications on ART therapy, which leads to unnecessary admissions in hospitals. Non-adherence also increases the possibility of patients developing ART-resistant ARV. The authors have clearly and adequately stated the problem in their work.
* How important is the nursing problem, and why?
Healthcare systems worldwide are strained by a range of problems, with an exponential increase in the number of users and staff shortages being some of them. This has led to burnout for nurses and an increase in mental health issues, which affects their productivity and ability to balance work and life. Solutions need to be sought on what can be done to alleviate the problem, and the research made that clear.
* What is the justification for this study?
The justification is that if adherence is increased, fewer admissions will be witnessed and ART-resistant patients will be reduced. This will improve patient outcomes and the nurses will have lighter workloads.
* Are there hypotheses, questions, or objectives stated? What are they?
There are no explicitly stated hypotheses or research questions, but the work has two objectives. The objectives are to examine ART adherence proportions and also identify factors influencing adherence.
* What theoretical or conceptual framework was used for the study? Which one? Was it clearly identified or only implied?
The only conceptual framework used was examining the causal relationship between the various factors and their influence o adherence to ART. It is implied and not identified. No specific theoretical framework was seen.
* How is the framework linked to the research purpose?
The framework is directly linked to the purpose since the research purpose was to investigate factors influencing adherence to ART in Ethiopian hospitals.
* How current is the research literature reviewed (consider the publication date of the paper)? Elaborate
Due to the exponential expansion in the body of knowledge, a generally accepted rule of the thumb is that a source should not be older than ten years. Looking at the article published in 2013, only one source stretches beyond 2003 to the year 2000, and that is quite commendable for work that relied on 27 sources.
* Is the literature review organized logically? Why or why not?
The literature review is logically organized. The authors have applied inductive and deductive logic in using the sources throughout the work.
* Does the literature review adequately support the need for the study? Elaborate
The literature cited is primarily in agreement with the problem of the study and hence giving credence to why it was plausible for the authors to conduct the research.
SECTION II: METHODS
* What is the study design?
A cross-sectional research design was used
* Does the design fit the purpose of the study? Elaborate
The design fits the purpose of the study since the study intended to survey how each of the factors and the influence on adherence correlated.
* How is the design linked to the sampling method and statistical analysis?
A systematic sampling method was used, and it ensured cohesion with the design and the SPSS statistical tool applied.
* Describe the sample as stated in the article. Is it adequately and clearly described in the article? Elaborate
The authors sufficiently describe the sample. In total, 338 respondents were selected, and all had to have had ART therapy at most 12 months before the study.
* Is the sampling procedure discussed in detail? Elaborate
The sampling procedure is also straightforward. It started with the random selection that is characteristic of systematic sampling. From there, every 4th person among the randomly selected was picked, and that is how the 338 respondents were selected.
* What do the authors provide as justification for the size of the sample?
No explicit justification for the sample size is provided.
* Describe the study protocol (treatment and/or procedures). Is it clear and concise?
The protocol is clear. Consent was to be sought from involved institutions and individuals. It was conducted ethically and analysis was done later to provide founded recommendations.
* What instruments are described in the article?
A questionnaire was used to collect data from respondents. A computer was also used to sort, code and enter data into the Statistical Package for Social Sciences (SPSS) software package. The data was presented through charts, graphs and frequency tables.
* Does each instrument measure the concept it is intended to measure? (Is the concept definition consistent with the operational definition?) Elaborate
All the instruments worked as intended. The computer provided outcomes in charts and tables. All this information was collected using the questionnaire, and they formed the basis for the analysis.
* Does the author(s) present information on the reliability and validity of the instruments? What do these terms mean? Elaborate
Testing for the questionnaire was done before the study on a small population with characteristics similar to the target group, and amendments were done to attain a Cronbach alpha accuracy of 0.625. Reliability refers to consistency in the instrument, while validity refers to the instrument's accuracy.
* How does the author address threats to internal and external validity that are inherent in the study design?
Strong inclusion and exclusion criteria was used to minimize selection bias. Data collectors were also made to know little about the respondents to avoid bias in the information.
* What evidence is provided regarding hu...