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The article "Analgesic Effect of Oral Sucrose and Pacifier during Eye Examinations for Retinopathy of Prematurity" (Mitchell, Stevens, Mungan, Johnson, Lobert, & Boss, 2004) is examined in terms of its quality and potential usefulness of the findings for nursing practice application. This study is a quantitative study

Title and Abstract

The title matches the major purpose of this study it contains the appropriate numbers of words making it straight forward rather than confusing to the reader. It is appealing and the topic is related to the practice of nursing.

The abstract is concise, meets the requirement of thoroughness and the view of the study variables were provided. It contains the purpose, the sample size, the research design, a brief description of the instrument, findings and the result. From the abstract the reader was able to determine if the study is of interest and whether or not to continue reading.

Purpose and Hypothesis

The purpose of the study was clearly identified at the end of the literature review which explained the authors determination to know the effectiveness of local aesthetic eye drops and a pacifier plus repeated doses of 24% sucrose in relieving pain associated with eye examinations for Retinopathy of Prematurity, Mitchell et al., p. 161, (2004). The purpose identifies the independent [doses of 24% Sucrose] and dependent variables [relieve of pain]. My opinion of the purpose statement is that it is clear and broadly indicates to the reader what is to be studied.

The research hypothesis is organized and well identified, and was stated as "There is a difference between the effect of a pacifier with repeated doses of 24% sucrose and a pacifier with repeated doses of sterile water to relieve pain during single eye examinations performed to detect or monitor ROP." The hypothesis is directly related to the research purpose and focuses on the effect of the independent variable. Directional form was used for the hypothesis and includes the study variables. There can be a null or alternative hypothesis. Based on a null hypothesis, there is no connection between the independent and dependent variables while the alternative hypothesis provides an alternative for the null hypothesis. The hypothesis is however testable.

Literature Review

The authors draw on pre-existing research to formulate the purpose of their own study. No studies are described in detail and not in terms of strengths and weaknesses. The authors clearly point out the gaps in the existing literature. "Studies that examined the effectiveness of NNS and oral sucrose have been carried out primarily during heel sticks and venipuncture. No research has been done on the pain associated with eye examination or on the effectiveness of developmentally sensitive interventions such as NNS and oral sucrose to relieve pain during eye examinations." Mitchell et al., (2004). While this is the case, they noted a particular difficulty inherent in this research literature, namely that no research has been done on this specific area of study. Generally, the review of literature seems comprehensive, the authors reference previous studies relevant to this study. In terms of being up-to-date, the literature review seems valid. That is, the article includes a well organized bibliographical reference list of 40 studies most of which were primary sources and were published between191986-2002. In addition, the literature seems to be directly related to the development of this study and is involved in the development of the research purpose and hypothesis .


The study assessed 184 preterm infant for eligibility but eventually only 30 randomly selected preterm infants who were hospitalized in a level 3 university affiliated Neonatal intensive care unit were part of the study. The sample size was therefore adequate and appropriate for an experimental study. The study had an inclusion criterion in that the infants had to weigh less than 1,500 grams at birth or weigh between 1,500 and 2000 grams at birth and require oxygen for more than 72 hours. The study also included infants who received first eye examination and those who received follow up examination, must not have previous exposure to sucrose analgesia. Researchers strive to eliminate all variation in subject characteristics and behaviors. The aim is to get greater precision in the estimate of the effect of the treatment. But the problem with this approach is that the effect generalizes only to subjects with the same narrow range of characteristics and behaviors as in the sample.

Research Design

The researchers explicitly stated that the study participants were randomly assigned to one of two treatments, it is an experimental technique to assign subjects to different treatments. Experimental studies provide the best evidence about how something affects something else. The participants were assigned to treatment group of anaesthetic eye drops and pacifier with sucrose, and control group of the anaesthetic eye drops and pacifier with water. This was done by a computer generated randomization program. In experimental study, bias is also less likely if subjects are randomly assigned to treatments, and if subjects and researchers are blind to the identity of the treatments, this is the case in this study. Mitchell et al., (2004). Claimed that "the researcher, the physician performing the eye examinations, and the research assistants scoring videotapes were blinded to the treatment received by each infant". Data collection methods are described in considerable detail as one would expect with a quantitative study.


Validity represents how well a variable measures what it is supposed to. This can be internal validity or external validity.

Internal Validity: the authors made no mention of possible threats to internal validity that may decrease the confidence in the result. But the researchers had stated that "it is important to note that although oral sucrose drops reduced pain during eye examinations in this study,



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