Evidence-based project, part 3: critical appraisal of research

USW1_NURS_6052_CriticalAppraisalTools1.doc
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Part2assignment.pptx

Evidence Based Project

Hector Gonzalez

Walden University

3/21/24

Introduction

Clinical Issue: Cardiovascular Disease

Significance: Major public health concern globally

Complexity: Multifactorial condition influenced by various factors

Focus: Lifestyle interventions for managing and preventing CVD

Importance: Addressing lifestyle choices crucial for effective management

Cardiovascular disease (CVD) is a rampant public health problem caused by multi-faceted etiology, including behavioral (e.g., lifestyle choices), genetic predisposition and comorbidities. Managing CVD successfully involves comprehensive strategies that target lifestyle modification with an emphasis on appropriate interventions. These interventions include daily physical activity, dietary changes, and adhering to medications regularly. Lifestyle adjustments are indispensable in the prevention and treatment of the complications of CVD. The targeting of lifestyle interventions to healthcare professionals can lead to significantly greater effects on patient´s health outcomes than any drug intervention and hence will lead to a reduction in the burden of CVD-related morbidity and mortality

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PICO(T) Question Development

Population: Older adults with cardiovascular disease

Intervention: Engagement in lifestyle interventions

Comparison: Standard care without structured lifestyle interventions

Outcome: Cardiovascular health outcomes

Timeframe: Within a specified period (e.g., 6 months to 1 year)

In the preparation of the PICO(T) question of the chosen topic, the population of interest is elderly patients diagnosed with cardiovascular disease. This intervention targets the sequential lifestyle changes approached with structured and constant treatment processes. The comparison is made with standard care non-intervention, and the outcome focuses on improvements in cardiovascular health markers. Assessment period most often covers a specified timeframe, such as within 6 months to a year. This structured way of approach help to design precise research questions that determine the evidence-based practice and clinical decision making.

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Research Databases Used

PubMed

CINAHL (Cumulative Index to Nursing and Allied Health Literature)

Cochrane Library

PsycINFO

Selection based on relevance to cardiovascular disease and lifestyle interventions

These databases were chosen based on their applicability to cardiovascular diseases and lifestyle interventions. PubMed maintains a huge source of biomedical information such as clinical research and reviews. CINAHL (Cumulative Index to Nursing and Allied Health Literature) focuses on nursing and allied health internationally by providing access to related research that all health personnel would require for patient care. The Cochrane Library is known for its evidenced-based decision-making through systematic reviews and evidence syntheses. PsycINFO is a psychological literature source. It is an excellent source to gain behavioral instructions which may contribute to the prevention and management of cardiovascular disease.

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Relevant Peer-Reviewed Articles

Alageel et al. (2020): Qualitative study on engagement with cardiovascular risk reduction advice

Ayatollahi et al. (2018): Perspectives of healthcare professionals on telemedicine in chronic disease management

Halloway et al. (2020): Mixed-methods study on feasibility of lifestyle interventions in older women with CVD

Jepma et al. (2021): Qualitative study on older patients’ perspectives toward lifestyle-related secondary cardiovascular prevention

The selected peer-reviewed articles convey the important information for the cardiovascular disease management by lifestyles. Alageel et.al, (2020) presented qualitative reflections about the process of patients when receiving information about their cardiovascular diseases, potentially a part of risk reduction advice. In the article by Ayatollahi et al. (2018), healthcare professionals share their knowledge and experience about the implementation of telemedicine to manage chronic diseases such as cardiovascular diseases. Halloway et al. (2020) conduct mixed-methods research for exploring the feasibility of lifestyle interventions in older adult females with CVD. Jepma et al. (2021) explore older patients' experience of lifestyle related secondary cardiovascular prevention through a qualitative study.

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Levels of Evidence in Selected Articles

Alageel et al. (2020): Qualitative study providing insights into patient perspectives

Ayatollahi et al. (2018): Perspectives of healthcare professionals

Halloway et al. (2020): Mixed-methods study combining qualitative and quantitative data

Jepma et al. (2021): Qualitative study capturing older patients’ perspectives

These chosen articles depict various levels of proof in the hierarchy of research designs. Alageel et al. (2020) offers the outcomes of a qualitative study, providing much-needed insight into what patients really think and feel about their illness. Ayatollahi et al. (2018) give first-hand accounts from health workers with notable contributions as health experts. Halloway et al. (2020), on the other hand, use mixed methods, which is a blend of both quantitative and qualitative data for a broad assessment. Jepma et al (2021) provide qualitative data, widening the view point of subjects aged 60 and above on lifestyle-related secondary cardiovascular prevention.

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Strengths of Using Systematic Reviews

Comprehensive synthesis of evidence from multiple studies

Enhanced understanding of interventions' effectiveness and feasibility

Valuable insights into patient perspectives, preferences, and experiences

Informs patient-centered care approaches

Guides the development of effective interventions for managing cardiovascular disease

Systematic reviews present a number of benefits while synthesizing evidence. They give a reliable summary of multiple studies by using different methods, which leads to a high level of confidence for the results. The systematic review is useful as healthcare workers get enhanced knowledge on intervention effectiveness as well as feasibility which is vital for good decision making. On top of that, systematic reviews are the gateway to patient-related information like perceptions, preferences, and experiences, which in turn can help develop strategies addressing patients' needs. Systematic reviews consolidate the evidence from multiple sources and inform the development of interventions that target a range of cardiovascular concerns.

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References

Alageel, S., Gulliford, M. C., Wright, A., Khoshaba, B., & Burgess, C. (2020). Engagement with advice to reduce cardiovascular risk following a health check programme: a qualitative study. Health Expectations, 23(1), 193-201. https://doi.org/10.1111/hex.12991

Ayatollahi, H., Mirani, N., Nazari, F., & Razavi, N. (2018). Iranian healthcare professionals’ perspectives about factors influencing the use of telemedicine in diabetes management. World Journal of Diabetes, 9(6), 92–98. https://doi.org/10.4239/\wjd.v9.i6.92

Halloway, S., Wilbur, J., Schoeny, M. E., Braun, L. T., Aggarwal, N. T., Miller, A. M., ... & Volgman, A. S. (2020). Feasibility of a Lifestyle Physical Activity Intervention to Prevent Memory Loss in Older Women With Cardiovascular Disease: A Mixed-Methods Approach. Canadian Journal of Nursing Research, 52(4), 278-289. https://doi.org/10.1177/0844562119856233

Jepma, P., Snaterse, M., Du Puy, S., Peters, R. J. G., Scholte op Reimer, W. J. M. (2021). Older patients’ perspectives toward lifestyle-related secondary cardiovascular prevention after a hospital admission—a qualitative study. Age and Ageing, 50(3), 936–943. https://doi.org/10.1093/ageing/afaa283

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Matrixworksheet.doc

Matrix Worksheet Template

Use this document to complete Part 1 of the Module 2 Assessment, Evidence-Based Project, Part 1: Identifying Research Methodologies

Full citation of selected article

Article #1

Article #2

Article #3

Article #4

Ayatollahi, H., Mirani, N., Nazari, F., & Razavi, N. (2018). Iranian healthcare professionals' perspectives about factors influencing the use of telemedicine in diabetes management. World Journal of Diabetes, 9(6), 92–98. https://doi.org/10.4239/wjd.v9.i6.92

Jepma, P., Snaterse, M., Du Puy, S., Peters, R. J. G., Scholte op Reimer, W. J. M. (2021). Older patients’ perspectives toward lifestyle-related secondary cardiovascular prevention after a hospital admission—a qualitative study. Age and Ageing, 50(3), 936–943. https://doi.org/10.1093/ageing/afaa283

Alageel, S., Gulliford, M. C., Wright, A., Khoshaba, B., & Burgess, C. (2020). Engagement with advice to reduce cardiovascular risk following a health check programme: a qualitative study. Health Expectations, 23(1), 193-201.

https://doi.org/10.1111/hex.12991

Halloway, S., Wilbur, J., Schoeny, M. E., et al. (2020). Feasibility of a Lifestyle Physical Activity Intervention to Prevent Memory Loss in Older Women With Cardiovascular Disease: A Mixed-Methods Approach. Canadian Journal of Nursing Research, 52(4), 278-289. https://doi.org/10.1177/0844562119856233

Why you chose this article and/or how it relates to the clinical issue of interest (include a brief explanation of the ethics of research related to your clinical issue of interest)

This article is relevant to the clinical issue of diabetes management, particularly the use of telemedicine which can significantly impact patient care and outcomes. Comprehending healthcare professionals' perspectives on telemedicine in diabetes management is essential for successful implementation and uptake of telemedicine technologies.

This qualitative study investigates the viewpoints of aged cardiac patients regarding lifestyle-related secondary preventions post-hospital admission. It explores various determinants influencing patients' moods and social influences regarding lifestyle modifications.

I chose this article because it directly relates to the clinical issue of cardiovascular disease (CVD) risk assessment and management which is a significant concern in healthcare. Understanding factors influencing engagement and adherence to lifestyle changes and medication is crucial for improving patient outcomes in CVD management.

This article was selected because it addresses the clinical issue of memory loss prevention in aged females with cardiovascular conditions, which is pertinent to overall health outcomes in this population. Exploring the feasibility and effectiveness of lifestyle physical activities interventions in this context is crucial for enhancing quality of life and reducing disease burden.

Brief description of the aims of the research of each peer-reviewed article

This research intends to identify factors influencing the use of telemedicine in diabetes management as perceived by healthcare professionals.

The study intends to investigate the views, social factors, and self-worth of older cardiac patients about lifestyle-related secondary preventions following hospitalization.

The research aims to examine factors influencing participation in and compliance to medications and lifestyle modification programs among people who have recently been determined to be at medium or high risk of CVD

.

The study aims to examine the feasibility, acceptability, and preliminary effects of a lifestyle physical exercise interventions to prevent memory decline in elderly women with cardiovascular conditions.

Brief description of the research methodology used Be sure to identify if the methodology used was qualitative , quantitative , or a mixed-methods approach. Be specific.

Quantitative study using a Likert scale questionnaire with thirty-seven questions.

This study employs a qualitative approach using semi-structured interviews with older cardiac clients.

Qualitative study using individual semi-structured interviews.

Mixed-methods approach combining quantitative measures with qualitative data collection through focus groups.

A brief description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

Quantitative methods provide numerical data for analyzing healthcare professionals' perspectives offering insights into the prevalence and distribution of attitudes and opinions. Statistical analysis enhances reliability and validity by quantifying responses and identifying significant associations between variables.

The qualitative methodology encourages thorough explorations of patients' perspectives and experiences thus offering rich and nuanced data. The study's focus on patient perspectives contributes to patient-centered care and may inform interventions tailored to older cardiac patients' needs.

Qualitative methods allow for in-depth exploration of participants' experiences, providing rich insights into their perspectives on CVD risk management. The Framework method enhances reliability and validity through systematic data analysis, ensuring rigorous interpretation of qualitative findings.

The mixed-methods approach provides a comprehensive understanding of intervention feasibility and effectiveness, combining objective measures with qualitative insights. Concept analysis enhances reliability and validity by systematically identifying themes related to intervention participation.

General Notes/Comments

The study's focus on healthcare professionals may overlook the perspectives of patients, which could be addressed in future research.

The findings of this study offer valuable implications for healthcare professionals aiming to engage older patients effectively in lifestyle interventions for cardiovascular health.

This qualitative study offers valuable insights into characteristics impacting cardiovascular disease risk persons' participation in and adherence to lifestyle modification programs and medicines

.

The research's use of self-reported measures may create biases and subsequent studies might integrate objective outcome measures for validation.

Matrix Worksheet Template

USW1_NURS_6052_CriticalAppraisalTools1.doc
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