Assignment: Critical Appraisal Essay

Assignment: Critical Appraisal Essay

A Sample Answer For the Assignment: Assignment: Critical Appraisal Essay

Title: Assignment: Critical Appraisal Essay

Assignment  Critical Appraisal Essay

A large volume of clinical research articles exist. The articles are similar and different in terms of their content, objectives, timelines, authors, methodologies, findings among other aspects. The variations make it hard to retrieve relevant articles that provide answers to the topic at hand. To determine the usefulness of an article, there is a need to critically appraise the suggested articles. The appraisal assists in the critical and systematic examination of research papers to determine their value, relevance, and integrity (Morrison, 2017).  Critical appraisal guides one in examining factors like internal validity and methods of study among others. The purpose of this paper is to critically appraise two qualitative and quantitative research articles by outlining their background, relevance, method of study, results, ethical considerations, and outcome comparisons.

 

Background

The selected quantitative articles were assessing the impact of mindfulness on nurse burnout. Gholizadeh et al. (2017) outlined that the nursing profession is stressful and requires the use of mindfulness practice to reduce pain systems and increase openness, agreement, and conscientiousness. The authors pointed out that although mindfulness results in decreased job stress, there is limited research examining the effects of a mindfulness intervention on job stress levels among nurses working in ICU. Penque (2019) also agrees that working in critical care and ED is stressful and results in burnout and increased intentions to leave the job. The negative impact should be mitigated by introducing a program like mindfulness-based stress reduction (MBSR) that teaches nurses to accept their lived experiences. MBSR decreases stress and burnout and enhances self-compassion. To find the effectiveness of MBSR, Penque (2019) executed a study that assessed job burnout, incidental overtime, work satisfaction, empathy, self-compassion, and mindfulness.

From the qualitative articles, Hugh-Jones, Rose, Koutsopoulou, and Simms-Ellis (2018) executed a study examining how mindfulness intervention reduces stress in the workplace. Hugh-Jones et al. (2018) pointed out that persistent psychological stress is associated with an inflammatory response that causes most of the chronic physical conditions.  The response increases the risk of coronary heart disease, major depressive disorder, smoking, overeating, and alcohol misuse among others. To reduce these risks, mindfulness-based approaches have been adopted in various workplaces. The authors aimed at establishing how workplace mindfulness-based interventions increase positive benefits. Lynch et al. (2018) indicated that rates of burnout and stress among healthcare practitioners are increasing. An affected area is the emergency department with a majority of staff reporting compassion fatigue, cynicism, depression, and suicide. The negative effects can be reduced using meditative practice like the mantra meditation (MM). MM results in improved self-reported spiritual well-being, stress, anger, anxiety, mindfulness traits and quality of life. Lynch et al. (2018) set out to obtain in-depth qualitative feedback on the ED staff’s experience of an MM program.

Articles Support the Nursing Issue

The PICOT question followed is “In nurses working at the intensive care unit, will the use of mindfulness-based practices compared to breaks reduce incidences of burnout among them?” The nursing issue under research is the reduction of nurse burnout among ICU nurses using mindfulness-based practice. The four articles support the issue because they are assessing the impact of mindfulness on

stress and burnout. For instance, Gholizadeh et al. (2017) look at how mindfulness reduces stress among ICU nurses. Stress is a major cause of nurse burnout. Penque (2019) on the other hand looks at how MBSR affects job-relevant factors like job burnout. Hugh-Jones et al. (2018) explain how mindfulness reduces stress in the workplace while Lynch et al. (2018) addresses the impact of mantra meditation on rates of burn out and stress among healthcare professionals working in the emergency department. In terms of the participants both Gholizadeh et al. (2017) and Penque (2019) have intervention groups receiving either mindfulness or MBSR respectively and control groups with no intervention. The proposed study has an intervention group receiving mindfulness-based practice and a control group receiving only breaks.

Click here to ORDER an A++ paper from our MASTERS and DOCTORATE WRITERS: Assignment: Critical Appraisal Essay

Methods of Study

For the quantitative articles, the methods used were randomized control trials and quasi-experimental design. Gholizadeh et al. (2017) adopted a randomized control study design that helps in the random assignment of participants into intervention and control groups whereas Penque (2019) used the quasi-experimental design which uses non-randomized intervention studies  (LoBiondo-Wood & Haber, 2017).   Gholizadeh et al. (2017) used RCT because it is a gold standard when determining causality and offers high-quality evidence that informs nursing practice. However, RCTs require clinical equipoise where the selected treatments have equal support in the clinical community (LoBiondo-Wood & Haber, 2017).  Penque (2019) used quasi-experiments because it eliminates the directionality problem. After all, one manipulates the independent variable before measuring the dependent variable (LoBiondo-Wood & Haber, 2017). A disadvantage of quasi-experiment is that it does not eliminate the problem of confounding variables since participants are not randomly assigned.

The qualitative articles employed semi-structured interviews (Lynch et al., 2018; Hugh-Jones et al., 2018). A semi-structured interview provides a large amount of information that is reliable and can be analyzed with ease. A limitation with the method is that it cannot infer cause and effects or compare answers (Kallio, Pietilä, Johnson & Kangasniemi, 2016).

Results

Gholizadeh et al. (2017) reported a significant difference between stress scores before and after implementation of the mindfulness intervention for both the control and experimental groups. A comparison of the two groups indicated no significant difference before the project however after the intervention a significant difference was noted. The authors concluded that mindfulness intervention can reduce job stress among nurses who work in intensive care units. The authors recommended that health centers and hospital managers should put mindfulness intervention training on their agenda as a way of enhancing the quality of health care services and patient satisfaction.  Penque (2019) also had positive results. MBSR reduced job burnout and improved specific psychological factors like mindfulness, self-compassion, and serenity. The author recommended the use of mindfulness-based programs among nurses to help them develop skills to manage clinical stress and improve their health. The program was also recommended because it increases overall attention, empathy, and presence with patients and families. Additionally, it increases work satisfaction, reduced incidental overtime and decreases job burnout.

The interviews by Hugh-Jones et al. (2018) were analyzed using a grounded theory which helped in generating a provisional model that explained how mindfulness led to positive changes. The model indicated that multiple, positive benefits were created by discrete, temporal experiences.  Mindfulness-based interventions increase attention, resonance, self-care, detection of stress markers and help in recovering self-agency. Lynch et al. (2018) found out that work pressure results in perceived stress which requires a wellness program to control. The staff indicated that medication increase attention and awareness, regulate emotion, enhance relaxation and sleep quality and generate coping mechanisms. Some participants reported feeling guilt for participating in the MM program while they can serve in other places. Barriers to practicing meditation were shift work, length of practice and individual differences. Facilitators were organizational support and internal support.

Implication on Nursing Practice

Gholizadeh et al. (2017) and Penque (2019) recommend the need to adopt mindfulness programs to help nurses’ redirect negative thinking and reframe difficult situations. The programs help nurses to handle stress, increase focus, awareness, and knowledge. Lynch et al (2018) recommend support to ensure that mediation programmers are embedded into busy hospital environments. The support can be offered as follow-up workshops and retreats and casual staff-organized group meditation sessions. Hugh-Jones et al. (2018) indicate that understanding how mindfulness programs work can increase engagement and trust as well as the ability to apply mindfulness in work life.

Ethical Considerations

Two ethical considerations needed when executing a project are voluntary participation of respondents using informed consent and ethical approval to safeguard the dignity, well-being, safety, and rights of all participants. Gholizadeh et al. (2017) do not outline whether they received approval or used informed consent, however, Penque (2019) states that she obtained approval from Institutional Review Board approval and participants had to willingly complete an informed-consent process. Hugh-Jones et al. (2018) also pointed out that ethical approval was received from the university research ethics committee while Lynch et al. (2018) advised participants to withdraw from the study at any time indicating voluntary participation.

Outcomes Comparison

The proposed study aims to determine whether mindfulness-based practice reduces nurse burnout among ICU nurses. The project primary outcome is reduced nurse burnout. The secondary outcomes assessed will be mindfulness, compassion-fatigue, and turnover rates and reduced stress. Gholizadeh et al. (2017) primary outcome was the average stress score measured using expanded nursing stress scale and job stress assessed using a questionnaire.  For Penque (2019) the study outcomes assessed were the impact of the MBSR program on mindfulness, self-compassion, empathy, and serenity. The instruments used are the Maslach Burnout Inventory, Index of Work Satisfaction, Interpersonal Reactivity Index, Brief Serenity Scale, Self-Compassion Scale, and the Brief Freiburg Mindfulness Inventory. Although not specified, thematic analysis by Lynch et al. (2008) revealed outcomes like work pressure and perceived stress, benefits of meditation, conflicting attitude, barriers to meditation and facilitators to meditation. Hugh-Jones et al. (2018) also generated themes like developing attention and awareness. All the outcomes are aimed at assessing the positive impact of mindfulness practice.

Assignment: Critical Appraisal Essay Conclusion

Critical appraisal of research articles helps in establishing their value, relevance, and integrity. As indicated above, four articles were appraised to illuminate the impact of the mindfulness-based practice on nurse burnout. The four articles indicate that working in ICU, critical care and emergency department increases stress among healthcare professionals. The stress results in burnout and increased turnover rates. The stress can be minimized using mindfulness practice, mindfulness-based stress reduction, mindfulness interventions, and mantra meditation. All these approaches result in better outcomes as indicated by positive results registered by the authors. The two quantitative studies appraised have adopted a randomized control trial design and quasi-experimental design while the qualitative articles used semi-structured interviews.  The articles show that mindfulness-based results in decreased stress, burn out and improved psychological factors like mindfulness, self-compassion, and serenity. The articles reveal a need to implement mindfulness interventions in nursing practice as a way of helping nurses redirect negative thinking and reframe difficult situations. The articles also have adopted the required ethical consideration with most of them getting approval and providing informed consent to participants. The outcomes of the analyzed articles also closely match the outcomes of the proposed project since all assess the positive impacts of the mindfulness-based practice.

Sample Answer for Assignment: Critical Appraisal Essay Included

PICOT Question

Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.

The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.

Refer to \”Research Critiques and PICOT Guidelines – Final Draft.\” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.

Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.

Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?

Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

• Your response needs to be a minimum of 150 words (not including your list of references)
• There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
• Include in-text citations in your response
• Do not include quotes—instead summarize and paraphrase the information
• Follow APA-7th edition
• Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

• A minimum of 6 responses per week, on at least 3 days of the week.
• Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
• Each response needs to be at least 75 words in length (does not include your list of references)
• Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
• Follow APA 7th edition
• Points will be deducted if the above is not followed
• Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
• Here are some helpful links
• Student paper example
• Citing Sources
• The Writing Center is a great resource