CONTINUATION OF EBP ASSIGNMENT
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WK7AssgnEBP2mycopy.docxAssignment: Evidence-Based Project 4: Critical Appraisal of Research
University
Evidenced Based Practice
Instructor
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Full APA formatted citation of selected article. |
Article #1 |
Article #2 |
Article #3 |
Article #4 |
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Katon, J. G., Callegari, L. S., Bossick, A. S., Fortney, J., Gerber, M. R., Lehavot, K., ... & Gray, K. E. (2020). Association of depression and post-traumatic stress disorder with receipt of minimally invasive hysterectomy for uterine fibroids: findings from the US department of veterans’ affairs. Women's Health Issues.
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Poyner, G. (2010). Psychological evaluations of veterans claiming PTSD disability with the Department of Veterans Affairs: A clinician's viewpoint. Psychological Injury and Law, 3(2), 130-132. |
Lancaster, C. L., Teeters, J. B., Gros, D. F., & Back, S. E. (2016). Posttraumatic stress disorder: overview of evidence-based assessment and treatment. Journal of clinical medicine, 5(11), 105. |
Kunimatsu, A., Yasaka, K., Akai, H., Kunimatsu, N., & Abe, O. (2020). MRI findings in posttraumatic stress disorder. Journal of Magnetic Resonance Imaging, 52(2), 380-396. |
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Evidence Level * (I, II, or III)
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Level I because the evidence comes from systematic review. |
Level I because the evidence comes from systematic review |
Level III because the evidence is from well-structured controlled trials not subjected to randomization |
Level III because the evidence is from well-structured controlled trials not subjected to randomization |
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Conceptual Framework
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No mentioned theoretical basis
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No sample was used. However, 1,000 mental health evaluations were conducted. |
Review of literature. |
The research has summarized the literature on the epidemiology, assessment, and treatment of PTSD. |
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Design/Method
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Cross-sectional study because the data was gathered at a single point in time from VA’s Fiscal Year 2013 to Fiscal Year 2014 chart. |
Systematic review Review of clinical case documentation |
The research has used systematic review |
Meta-analyses |
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Sample/Setting |
The research involved only veterans with a hysterectomy at VA and a diagnosis of uterine fibroids. The sample was 770 veterans. |
No sample was used. However, 1,000 mental health evaluations were conducted. |
No sample was used for the research. Instead, different literature has been reviewed to arrive at the research summary and conclusion. |
No stated sample |
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Major Variables Studied
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Independent variable; Uterine size, surgery time, abdominal hysterectomy Dependent variable: depression and PTSD |
The research lacked clear variables for study |
Independent variable: discontinuation of pharmacotherapy Dependent variable: PTSD symptoms, relapse |
Independent variable: Avoidance, intrusion symptom, negative alterations, and reactivity Dependent: PTSD |
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Measurement
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95% confidence intervals (CIs) |
100 diagnostic or follow-up evaluations of veterans |
No actual numbers Independent variable: discontinuation of pharmacotherapy Dependent variable: PTSD symptoms, relapse |
No actual numbers |
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Data Analysis Statistical or Qualitative finding |
Generalized linear tests of 770 veterans. |
1,000 mental health evaluations |
No actual tests done to answer the clinical question. |
Existing source data from multiple sites with |
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Findings and Recommendations
General findings and recommendations of the research |
Veterans with depression or PTSD are prone to abnormal uterine bleeding. They have at least one gynecologic diagnosis compared to those people without depression or PTSD. Individuals with depression or PTSD are more vulnerable to nulliparous than those without depression or PTSD. The recommendation is that it is necessary to understand the complex interactions between mental health and symptom experiences and treatment preferences specific to uterine fibroids. This understanding will maintain high-quality, patient-centered gynecology care. |
Millions of veterans do not have PTSD. Researchers should research more on veterans with PTSD using quantitative research to get reliable and valid findings. |
PTSD is a prevalent, debilitating psychiatric disorder. Discontinuing pharmacotherapy treatment among people with PTSD is related to relapse. Psychotherapy leads to infrequent relapse. The research does not provide any recommendations for further study. |
MRI findings on PTSD are that people with PTSD have anterior cingulate bundle. The stringency to control confounding factors, involving comorbidity and status of medication vary across the concerned studies. People with PTSD indicate hyperactivity in the bilateral cerebellar hemispheres, in contrast to the observation in the cerebellar pyramids when compared with all controls. |
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Appraisal and Study Quality
Describe the general worth of this research to practice.
What are the strengths and limitations of study?
What are the risks associated with implementation of the suggested practices or processes detailed in the research?
What is the feasibility of use in your practice? |
The research provides an in-depth understanding of PTSD among individuals based on evidence findings and helps therapists advance their field. Findings are easy to generalize because the selection process is well-structured, and the sample represents the study population. The research limitation is that the secondary data is unavailable and difficult to access. The research does not recommend practices for implementation.
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The research knowledge will help in changing how psychiatrist will assess veterans to determine the PTSD disability. Multiple databases were searched, and it has a relevant reference list of previously researched articles. Conflict of interest is not outlined. No recommended practices. |
The research closes a knowledge gap in clinical practice. Data is descriptive; thus, the findings’ generalizability is limited. No recommended practices |
This research expands knowledge on how different brain parts play role in PTSD. The metal-analysis approach of the research gives in-depth view of the topic being studied. This analysis is valuable for descriptive research. As with all techniques of gathering data, the research methodology has drawbacks. First, while one might argue that meta-analyses are flexible in the concept, a number of questions can get asked about the topic. The research discovers underlying threats to brain parts that may lead to development of PTSD in a person. |
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Key findings
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There is a positive relationship between mental health disorders, depression and PTSD, and MIH among veterans living with uterine fibroids. |
There are fraud and abuse in veterans' PTSD disability claims. The number of veterans claiming to have PTSD disability has increased for compensation. |
Brain stimulation techniques and neuronal feedback outside psychotherapy and pharmacotherapy assist in reducing PTSD symptoms. |
The of the meta‐analytic results may be driven by factors besides PTSD symptoms |
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Outcomes
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No outcome |
No outcome |
No outcome |
No outcome |
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General Notes/Comments |
The research findings’ limitations give way for future research. The conclusion depicts the research findings.
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The research findings are not presented clearly. A reader struggles to get the research flow because it lacks variables, methodology, summary, and conclusion. |
The methodology provides reliable and valid findings on the conducted research. The findings of the research in this new field are conflicted. |
The research’s presentation of review of literature is exemplary. This review gives the best meta-analysis for finding valid findings. |
Critical Appraisal Tool Worksheet Template
Part B
From the reviewed research, psychotherapy emerges as the best practice for people with PTSD (Lancaster et al., 2016). Among veterans, evidence-based psychotherapies Cognitive Processing Therapy (CPT) improves the condition of a patient. This CPT depends much on interventions that directly aim maladaptive thinking of a person. With other therapies related to cognitive for PTSD, CPT focuses on the role that maladaptive or incorrect interpretation of a situation contributes to maintaining mental disorders such as PTSD and intervenes directly with the thoughts instead of resulting behaviors. In the research review, PTSD is the most common devitalizing mental disorder. Relapse is associated with discontinuing treating using pharmacotherapy approaches in people living with PTSD. This psychotherapy contributes to infrequent relapse.
Pharmacological treatments are evidence-based. However, psychotherapeutic treatments are the most preferred option for treating individuals with PTSD. Compared to psychological treatments, pharmacotherapies are also given to the most clinical contexts. They need much less time and commitments on the patient's part, such as fewer and short appointments, avoiding homework between visits. The basis of pharmacological interventions supports the increasing literature for the relationship between PTSD and dysregulations in systems of neurotransmitter and neuroendocrine. In the United States, it is estimated that 8% of the population live with PTSD (Lancaster et al., 2016). The research review focused on the side effects of using different treatments, pharmacotherapy, and psychotherapy. The latter was the most effective intervention for people with PTSD since pharmacotherapy causes relapses among patients.
