Clinical Problem Research Critique

Posted: December 23rd, 2022

Clinical Problem Research Critique

Use the practice problem and a qualitative, peer-reviewed research article you identified in the Topic 1 assignment to complete this assignment. In a 1000-1,250 word essay, summarize the study, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study. Refer to the resource “Research Critique Guidelines” for suggested headings and content for your paper. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. Clinical Problem Research Critique . This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center. RUBRIC 75.0 %Content 15.0 %Background of Study Background of study including problem, significance to nursing, purpose, objective, and research questions is incomplete. Background of study including problem, significance to nursing, purpose, objective, and research questions is included but lacks relevant details and explanation. Background of study including problem, significance to nursing, purpose, objective, and research questions is partially complete and includes some relevant details and explanation. Background of study including problem, significance to nursing, purpose, objective, and research questions is complete and includes relevant details and explanation. Background of study including problem, significance to nursing, purpose, objective, and research questions is thorough with substantial relevant details and extensive explanation. 15.0 %Method of Study Discussion of method of study including discussion of conceptual/theoretical framework is incomplete. Discussion of method of study including discussion of conceptual/theoretical framework is included but lacks relevant details and explanation. Discussion of method of study including discussion of conceptual/theoretical framework is partially complete and includes some relevant details and explanation. Discussion of method of study including discussion of conceptual/theoretical framework is complete and includes relevant details and explanation. Discussion of method of study including discussion of conceptual/theoretical framework is thorough with substantial relevant details and extensive explanation. 15.0 %Results of Study Discussion of study results including findings and implications for nursing practice is incomplete. Clinical Problem Research Critique . Discussion of study results including findings and implications for nursing practice is included but lacks relevant details and explanation. Discussion of study results including findings and implications for nursing practice is partially complete and includes some relevant details and explanation. Discussion of study results including findings and implications for nursing practice is complete and includes relevant details and explanation. Discussion of study results including findings and implications for nursing practice is thorough with substantial relevant details and extensive explanation. 15.0 %Ethical Considerations Discussion of ethical considerations associated with the conduct of nursing research is incomplete. Discussion of ethical considerations associated with the conduct of nursing research is included but lacks relevant details and explanation. Discussion of ethical considerations associated with the conduct of nursing research is partially complete and includes some relevant details and explanation. Discussion of ethical considerations associated with the conduct of nursing research is complete and includes relevant details and explanation. Discussion of ethical considerations associated with the conduct of nursing research is thorough with substantial relevant details and extensive explanation. 15.0 %Conclusion Conclusion does not summarize a critical appraisal and applicability of findings. Conclusion is vague and does not discuss importance to nursing. Conclusion summarizes utility of the research and importance to nursing practice. Conclusion summarizes utility of the research from the critical appraisal and the findings importance to nursing practice. Conclusion summarizes utility of the research from the critical appraisal, knowledge learned, and the importance of the findings to nursing practice. Clinical Problem Research Critique . 15.0 %Organization and Effectiveness 5.0 %Thesis Development and Purpose Paper lacks any discernible overall purpose or organizing claim. Thesis is insufficiently developed or vague. Purpose is not clear. Thesis is apparent and appropriate to purpose. Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. 5.0 %Argument Logic and Construction Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. Argument is clear and convincing and presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. 5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use) Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used. Writer is clearly in command of standard, written, academic English. 10.0 %Format 5.0 %Paper Format (use of appropriate style for the major and assignment) Template is not used appropriately or documentation format is rarely followed correctly. Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent. Template is used, and formatting is correct, although some minor errors may be present. Template is fully used; There are virtually no errors in formatting style. All format elements are correct. 5.0 %Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) Sources are not documented. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. 100 %Total Weightage. Clinical Problem Research Critique

Clinical problem that Led To the Study

According to the study by Yang et al., (2017), the research problem was a gradual increase in the prevalence of hypertension among patients seeking primary care. It was understood that hypertension was a risk factor for cardiovascular illnesses yet it could basically be reduced by up to 42%. The researchers also mentioned that globally, hypertension was a major risk for heart diseases and premature deaths since it its initial diagnosis is difficult to make until the occurrence of medical complications.

Reference is made to previous studies which cite Hypertension as difficult to effectively manage since the ideal management requires that several patient’s characteristics such as age, sex, exercise, medication adherence, race and diet are considered, since they also influence cardiovascular risk. According to the researchers, effective control of blood pressure and reduction of the cardiovascular risk cannot be achieved through the conventional use of medications alone. Yet, most studies rarely focus on the effect that lifestyle modification has on the blood pressure control, more so in East Asia. Clinical Problem Research Critique

The significance of the Study

Yang et al., (2017) estimate that, in the adult global population, 20% has hypertension. Besides, it is a leading cause of mortality, premature deaths, morbidities and a risk for cardiovascular disease. In Korea in 2013, this prevalence among adults above 30 years of age was estimated at 27.3%. It was also noted that hypertension and its complications have huge amounts of direct and indirect costs.

Purpose of the Study

Yang et al., (2017) sought to as to identify the modifications in lifestyle which are linked to effective blood pressure control and reduce cardiovascular risk among hypertensive patients.

Research Questions

Which lifestyle modifications are associated with effective control of blood pressure and reduce cardiovascular risk among hypertensive patients?Clinical Problem Research Critique

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Method of Study

Qualitative Methods and the Research Problem  

The qualitative methods used to answer the research question included the use of survey’s questions at the initial inquiry followed by outpatient clinic inquiries at the fourth, eighth and twelfth weeks. Survey questionnaires were filled by the participants at the initial appointment and additional questionnaires were administered as a follow-up during every follow-up clinic visit. The information filled included basic characteristics of education, intake of alcohol and tobacco smoking, income, salt intake habits, comorbidities and BMI (Yang et al., 2017). The IPAQ (International Physical Activity Questionnaire)-short form was used to evaluate physical activity. Since the research question was to identify the lifestyle modifications associated with effective control of blood pressure and reduction of cardiovascular risk among hypertensive patients, the qualitative methods were appropriate.Clinical Problem Research Critique

Perspective from Which the Study Was Developed

Patients with hypertension who had newly been prescribed candesartan were recruited and retrospectively assessed. Preliminary assessments were done on the lifestyle of the participants through survey questions with regards to smoking tobacco, taking alcohol, sodium intake and physical activity. Besides, Yang et al., (2017) specified that the study was an added analysis of a RCT trial on the effect that reminders through text messaging using mobile phones had on lifestyle modification and medication compliance among hypertensive clients.

Qualitative and Quantitative Literature Included By the Author

Yang et al., (2017) cited previous qualitative studies that sought to determine the effect of enhanced interventions on the screening, management and health behaviors of newly diagnosed hypertensive patients. This literature cites the positive effects of various interventions on hypertension management but less significant effects were shown by lifestyle changes.

References Used

Although the study by Yang et al., (2017) included qualitative and quantitative studies which were older than 5 years, the findings were applicable to this qualitative study.

Weaknesses of Available Studies

The author mentioned that available studies on the effect of lifestyle modification on the control of hypertension and cardiovascular risk reduction do not provide sufficient information on how lifestyle modification can be used as an intervention in the management of hypertension (Yang et al., 2017). Clinical Problem Research Critique

Adequate Information In the Literature Review To Build A Logical Argument

In the literature review, the researchers used information from past and current sources that were related to lifestyle modification in the management of hypertension. Through the use of this information, it was possible to identify and fill the potential gaps in knowledge with other studies and the findings of this study thus building a logical argument.

Results of Study

Study Findings

Out of the 1453 participants, initial blood pressure data were available for 1139 patients up to 12 weeks. The average population of the study had were 64 years on average with 60% female and 40% male. Of the 139 participants, the success group had 961(84%) while 178 (16%) were in the failure group.  The baseline characteristics of success and fail groups both showed statistical significance in terms of gender, age, education, income, use of alcohol, salt intake, BMI, family history of hypertension, both the fail and success groups showed statistical significance (Yang et al., 2017).  After a thorough analysis of the factors linked to effective hypertension control using the multivariate approach, salt intake, comorbidity and gender were linked to fruitful blood pressure control. A univariate approach showed that a high BMI, Lack of physical activity and high salt intake resulted to a poor blood pressure control (Yang et al., 2017).

Implications To Nursing

The findings of this study imply that, in the clinical management of hypertension, the use of medications alone is not effective to control blood pressure and unanticipated cardiovascular events. Instead, including lifestyle modification in the management has proven to be highly effective in reducing cardiovascular risk and effective blood pressure control. Therefore, nurses should emphasize lifestyle modification interventions alongside the use of medications in managing effective blood control and cardiovascular risk reduction in hypertensive patients. Clinical Problem Research Critique

How Findings Contribute To Nursing Knowledge/Science

The findings of this study add to the already available knowledge on the management of hypertension. It also provides knowledge on how cardiovascular complications can significantly be reduced in hypertensive patients. In clinical nursing practice, nurses should encourage patients with hypertension to engage in daily aerobic physical exercise and reduce salt intake. Sympathetic activity tends to reduce through physical activity which also improves endothelial function. As a result, the risk to cardiovascular events is gradually reduced. Besides, nurses should recommend dietary modifications to hypertensive patients with the assistance of nutritionists. Dietary modification should include: reducing sodium intake, moderating the intake of alcohol, weight loss through dietary modification thus taking a lot of vegetables, fruits, legumes, low fats, low snacks and low saturated fats.Clinical Problem Research Critique

Ethical Considerations

The Institutional Review Board of the Asian Medical Center (2008-0290) approved this study. Besides, the participants were not required to provide any identifiable information and this helped to protect patient privacy. Since the patients were not subjected to any drugs/treatment, no major ethical considerations were included in this context.

Conclusion

Hypertension is a chronic illness of public significance due to its gradual increasing prevalence and related medical costs. Maintaining an effective control of blood pressure with the sole use of medications has proven to be inefficient as individuals are still exposed to cardiovascular risks which lead to premature deaths and morbidities. It is for this reason that lifestyle modification should be encouraged alongside hypertension medication adherence in the management of hypertensive patients. Lifestyle modification has also proven to reduce cardiovascular risks in hypertensive patients.

In clinical practice, nurses should encourage patients with hypertension to engage in daily aerobic physical exercise, reduce salt, alcohol and tobacco smoking. Through the guidance of a nutritionist, patients should also be helped to develop dietary timetables which are low in fat, sugars, and snacks but high in vegetables and legumes. This also helps in weight reduction and achieving a normal BMI. These approaches have generally proven to be potential in improving control of blood pressure, reducing the need for medications and cardiovascular complications.

References

Yang, M. H., Kang, S. Y., Lee, J. A., Kim, Y. S., Sung, E. J., Lee, K. Y., Kim, J. S., Oh, H. J., Kang, H. C., Lee, S. Y. (2017). The Effect of Lifestyle Changes on Blood Pressure Control among Hypertensive Patients. Korean journal of family medicine, 38(4), 173-180. Clinical Problem Research Critique