Nursing- Evaluation Of Evidences - Assessment Answer

December 20, 2018
Author : Ashley Simons

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Evaluation Of Evidences

Evaluation Of Evidences


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The essay is based on providing the critical appraisal of two different studies. The first paper discussed in the essay is “A Pilot Study Examining the Effects of Kouk Sun Do on University Students with Anxiety Symptoms” and the second study used for the critical appraisal is “Reduced emotional stress reactivity to a real-life academic examination stressor in students participating in a 20-week aerobic exercise training: A randomised controlled trial using Ambulatory Assessment”. Both the studies are related to provide the efficiency of two different physical exercises. The critical appraisal will be used to support the case scenario of Mariana. Mariana is a student at an Australian University, and a single mother. She is facing real life stress events. Thus, essay will provide the evidence based critical appraisal to justify the importance of relevant exercise for Mariana.

Paper 1

The first paper is associated with the study of Kouk Sun Do (KSD), which is a mind-body exercise. The paper is based on identifying the effect of exercise on mental health of the university students. The study included 30 university students, who self reported anxiety symptoms. The study explains that vital reason behind mental disorders is anxiety, which is supported with relevant literature references. The study also explains that anxiety not only affects the mental state of a person, but also affects the physical mobility and well-being of an individual (Kessler et al, 2005). The study is based on the S5 evidence hierarchy. That starts with providing the relevant and systematic review of the studies. The topic of the study is to evaluate the effectiveness of the Korean Kouk Sun Do (KSD) exercise.

The evidence based practice attempts to validate the effectiveness of the evidences proposed in the study. The article provide the evidence based study and validates the review by providing comparison with other mind and physical exercises and evidences based on peer reviewed journals. The synthesis of the evidences is based upon the comparison done with other stress reducing exercises like different kind of yoga poses (Brown, & Gerbarg, 2009). The study also provides the evidence based review of the different breathing pattern associated with mental exercises (Posadzki, Parekh, & Glass, 2010). The therapy explained in the article is based on randomized controlled trial. The topic is critically appraised in the study with help of relevant resources.

The main purpose of the cortically appraised topic is to provide the short summary of the resources, which are considered as the best available resources by the author. Considering the evidence based guidelines, the study provides the summary and less rigorous version of the review of articles. However, the best available evidences related to Kouk Sun Do (KSD) exercise are provided in the study. The study also validates the information provided, by using current resources. The study also focuses on providing the wide range of information associated with the topic chosen, instead of specific and limited information. The study also refers the evidences to the clinical question. The resources are comprehensive and used the potentially biased search strategy. The database included in the study is done through authoritative coverage of the relevant literature. All the resources are related to the nursing and allied health journals, books, peer reviewed papers and also empirical studies. The author effectively completed the literature review and randomly presented the findings of the articles. The author provide the balanced in the selection of the resources. The study is based on the qualitative analysis of the data retrieved from the randomized control trial of the 30 participants.

The only bias used in the study was that participants should be presently experiencing the symptoms of anxiety. The study also verifies the ethical consideration of the research, as this project was approved by the Institutional Review of the University’s board. The participants were informed prior to the test and had signed the concern form before the study started. The study provides the details about the case control studies and cohort studies. Levels of evidences offered in the study are from level V, it is because it provides the systematic review of the qualitative studies. The strength of the study is that it provides qualitative data based on the open-minded questionnaires. The study also validates the result of the previous studies. The limitation of the study is that it is based on the small size of the samples that may lack the statistical validity of the results. Another limitation of the study is that it measures that data as the immediate effect of the test, but it lacks follow-up study.

Paper 2

The main objective of the study is to examine the effect of 20-week aerobic exercise intervention (AET) on improving emotional stress reactivity during real-life stress. The study is based on S6 evidence hierarchy. The design of the study is based on randomized control trial, within subject design. For the purpose of the study 61 students were randomly chosen, who were also considered as inactive. These students were included in the waiting control and an AET group. For the purpose of the collecting data (which was situation specific and intra-individual) was collected and assembled through the use of electronic diaries. This further validates the use of computerized decision support systems. The evidence based studies are used for this research.

The abstract and introduction of the study provides the clear purpose. The systematic review of the study provides the details about the relevant resources used. The method of the study also states that detail about the study population. The study focuses on the perceived stress and moods of the participants. The author based the study on various psychological and physical aspects of the health. According to the literature review the level of stress is affected by the daily stresses, which display negative psychological impact. The study provides the examples from various evidence based text books and evidence based peer reviewed journals. According to the information included in the study, physical exercise and other physical activities helps in reducing the level of stress. The author supports this statement by referring to the ‘stress-buffer hypothesis’ (Gerber & Pühse, 2009; Hamer, 2012; Sothmann, 2006; Tsatsoulis & Fountoulakis, 2006). The study also provides the information about the laboratory studies that explain the effectiveness of the physical exercise and positive impact of exercise on the mental health of an individual. Thus, author has validated the aim of the research with the help of current and relevant resources.

The author has also included various evidence based cross-sectional studies in the research that defines about various stresses related tests. Thus, the study includes various randomized control trials to validate the importance of the physical activities and exercises. The main aim of the study is to focus on the daily stress in real life circumstances, which is clearly well researched and assembled. The cross-sectional studies (Baghurst & Kelley, 2014; Poole et al, 2011) used by the author are correlated to the daily life stressful events and physical exercise, as this study explains the effectiveness of aerobic exercise intervention (AET). The study also validates its effectiveness by including the critical appraisal of the resources (Giacobbi et al, 2007).

The study also validated its point of supporting physical exercise by providing the resources about positive affect (PA) of physical exercise. The findings of the research support the PA, participants have less stressful events on exercise days in comparison to non-exercise days. 2012). None of the studies addressed any effects of regular exercise on emotional stress reactivity during real life. The study found that previous studies could not provide the clear view about the negative effect of the enhanced emotional reactivity in the daily life to reduce real life stressors. For the purpose to verify this approach, author also conducted the randomized control trial by the use of Ambulatory Assessment (Trull & Ebner-Priemer, 2013) in order to overcome the shortcomings of the previous studies. The study investigated the 20-week aerobic exercise intervention to find out the reduction in the emotional stress reactivity in real life. The samples collected from the sixty one electrical engineering students in two groups. For the systematic review of the literature, resources were selected from various nursing journals like Pubmed and Cochrane.

The study used the Multidimensional Mood Questionnaire (MDMQ) for validating Ambulatory Assessment. The study also provides the empirical evidences of the data collected. The findings of the study are also supported by various contemporary resources and evidence based studies. The strength of the study is in finding that exercise can be used as an effective and preventive method for reducing stress induced negative effects on the health of an individual. Ambulatory Assessment is also found to be an effective method. The study also provided the effective and important findings about the aerobic exercise and its impact on emotional stress reactivity. The limitation of the study is that the results of the study are not representative, as the test was conducted on young and healthy students, who already have low level of negative affects (NA) of stress and mild level of perceived stress (PS). The enrollment of the participants in the study was voluntarily, thus it is possible that students with higher level of stress may have not participated. The level of the evidences found in the study is from Level I, as they are based on randomized control trials.

Justification of the Evidences

The first paper is “A Pilot Study Examining the Effects of Kouk Sun Do on University Students with Anxiety Symptoms” (Kim, Yang, & Schroeppel, 2013). This paper is based on providing the evidences about the positive impact of Kouk Sun Do (KSD) on the mental health of the students. The paper collected the data from the University students, as it states that university students are more affected by stress and anxiety. The study collected the subjective data by self-reporting of the perceived anxiety symptoms. Though, the evidence and findings of the paper, the Korean exercise is effective in reducing level of stress, but it does not provide a wide array of the resources and case based studies. The systematic review of the literature offered is very limited. The qualitative data collected through this research study is based on the open-ended questions, such as “(1) What did you like about the KSD exercise the most?; (2) What did you like the least about the KSD exercise?; (3) What do you think about the benefits of the KSD exercise?; and (4) What is your overall impression about the KSD exercise?” (p. 101). The use of open ended question could validate the reliability of the results, as the answers of these questions were based only of the view of the participants. Also, the data collected was done immediately after the completion of the test and no follow-up data was found, which also questions the effectiveness of the KSD exercise in daily life. The categorization of the data collected is not supported by current resources and data analysis lack supportive resources.

The second study provides the more comprehensive details about the resources used. The study also used various randomized control trials to validate the aim of the research. The study also provided the significant effect of the aerobics exercise on the emotional stress reactivity. The study also compared the effect of exercise on various physical and psychological functioning. This article provides the best evidences for the Mariana’sscenario. This article provides the relevance of the exercise in relation to the real life stressful episodes. This study also describes the emotional stress reactivity with the help of relevant support of literature. The sources used in the study are mainly cross-sectional randomized control trials. The comprehensive research has been done by the author to find the relevant research material, which provides the essential information about mood and emotional stress for Mariana. The study also explains that how the response to aerobic exercise differs with change in age, target group, baseline vagal tone, genetic disposition, gender and training load. Thus, this study is helpful for the stress reduction in the case of Mariana.The strength of the study is also validated providing the assessment of two different times (before and after exams).

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