Minor Stroke: Journal Analysis - Essay Example

?Journal Analysis: Accurate Question and Answer Essay Context of the Paper 1. The research paper sought to examine the impact of the community-centered program regarding prevention of stroke progression in citizens who previously suffered minor stroke. Specifically, it aspired to answer behavioral and knowledge efficacy of the programme, including health information of stroke, involvement in self-monitoring parameters, adoption of healthier lifestyle, and physical improvements from identified disease risk factors. 2. Research Method 2.1. The study is qualitative in research process, wherein the quasi-experimental design had been indicated. As described by Berg and Latin (2007), it is qualified due to non-randomised sampling technique in classifying the subjects into controlled and non-controlled groups. This is still appropriate for current study require the observation of samples in their natural, reality-based settings, as is the quality known in quasi-experimental design. It assists in effectively observing the occurrence of enhanced knowledge to behavior of the subjects in scrutiny, as opposed to experimental type, where experimental manipulation of groups may reduce reliability of the study in natural community settings. . 2.2. There are two groups created in the said study, intervention and controlled group. The latter group had been provided with the usual treatment intervention seen in health settings, where health providers do the active teaching routine while care recipients passively receive the information with little feedback and knowledge evaluation, with the inclusion of health promotion materials such as stroke-related informative pamphlets. By this, learning is more like the “spoon-feed” type, where information are already presented without assessing the health information needs of participants. In contrast, there is an active collaboration between health personnel and community citizens in the former collection. During the 8-week education program, active teaching pedagogy through two-hour meeting was provided. Education on prevention of stroke risk factors, and possible management during acute cerebrovascular attack are discussed, where discussions are highly individualized--letting the participants choose the sets of priority, from their lifestyle, health monitoring practices, medication and physical activity compliance. As goals are established and plans are interactively constructed, learning skills are put into application through implementation of agreed plans. In evaluation of weekly progress, personal logs are answered and pedometer was utilized to assess physical activity. All these were then taken up and discussed during meetings, giving participants time to reflect on their progress and status. 2.3. The cognitive and behavioral strategies utilized by the said projects serve as independent variable, while health attitudes and information-enhancing behavior in the participants with stroke conditions are dependent variables. As explained by Connaway and Powell (2010), variables are research properties that change the course of the study, which are not fixed in context, further expounding that independent variables are main influences that experimentally alter study outcomes, while dependent variables rely on the former variable type for its function. As such, health attitudes and behavior of participants depend on introduced educational strategies; the former depends on the latter, while the latter serves as main factor--causing change on the study. 2.4. A structured questionnaire had been mainly used in the study, with four main categories dividing the information into specific information background: “demographic profile, lifestyle habits...medication compliance, (and) stroke knowledge” (Sit et al., 2007). Collected through personal interview sessions, background data are accompanied by basic assessment of health status related to cerebrovascular (stroke) condition, such as risk factors in blood pressure, cholesterol level, total fat percentage, and proportionality of weight and height (BMI). In retrospect, the questions related with the information to be drawn are expected to reflect the predicted changes in participants, both in knowledge capacity, health attitudes and behavior. 3. External Validity of the Study 3.1. From various geographical regions in China, initial number of samples reached 190 people, but only 147 subjects finished the study. There were a number of requirements that researchers provided before the said samples are allowed to participate. Substantially, they should be of legal age, from 18 years to older adult years, medically diagnosed to have stroke, although clinically stable, and must not have compounding cereborvascular diseases and chronic medical conditions requiring clinical procedures, physiologically capable of daily activities with intact cognition, and can speak the local language (Cantonese). If all these criteria are met, volunteers can have a higher chance of being included. 3.2. There is a lack of detailed description on how sample populations had been recruited, whether it had been done voluntarily, or whether they are persuaded for a number of incentives, and where the concentration of participants had been collected. In assumption, there seemed to be a voluntary inclusion of participants, which is appropriate for their willingness to cooperate and ensure their continuity in the study until the end. 3.3. The distribution of samples had been done in non-randomized procedure through the time slot selection. The chosen samples are designated between intervention and control group through an alternating exercise scheme, where those who had executed exercise on odd patterns went intervention cluster while the even ones are in controlled set. However, the numbered slots can generate biases for the samples can be chosen to represent some qualities to make the study more distributed, such as amount of physical involvement in exercise, hence, its unsuitability as sampling selection method. 3.4. On initial study implementation, there was no difference between the control and intervention group, for all of them passed the qualifying requirements set by researchers, however, near the outcome phase, health comprehension and better health-related attitudes are observed in the latter with the application of educational strategies on stroke prevention, giving way for improved difference between the two study sets. 3.5. The dropouts of the study had been unable to continue due to unpredictable reasons that were out of participants’ control to resolve. Some had either been admitted in hospitals or sought medical attentions in other regions; others migrated in other countries, while only the loss of contact with participants remained the only reason that could have been managed. The sets of reason for dropping out showed that some of them had not been screened well for worsening conditions, which had been one of the standards for sample selection, while the contact failure exhibited lack of interest in the study, unlike the remaining samples who finished the whole research process. 3.6. Yes, the study can easily be replicated due to its achievable sample requirements and broad outcome parameters. As pointed out by Houser (2007), this refers to external validity, where study outcomes can be generally applied in other studies of different settings but of similar sample parameters. As there are better stroke-related comprehension and lifestyle behaviors in participants in the intervention group, these can be used as standard measurement for the efficacy of stroke prevention approach in other regions and cultural groups. 4. Internal Validity 4.1. Reliability is one of the research requirements that provides considerable strength on relevant studies. Jackson (2008) described this concept as the consistency of utilized methodological instruments, where their application in similar study settings should yield linear statistical outcomes. In the study, there had been a mixture of instruments used deemed appropriate. The inclusion of these measures in the content of the interview had been relevantly appropriate and further statistical evaluation manifested its reliable value on the rate of 0.86 relative to the standards in Kappa statistics and Spearman Rho correlation--1-0.78 and .078-0.96 respectively. 4.2. The value of the concept in validity is based on structured mechanisms through application in identified variables believed to be tangible, and accurately efficient in delineating research process and predicted outcomes (Karlsoon, 2008). This is mainly divided into two concepts, the internal and external validity of research studies. The latter category had been well-demonstrated by the outcomes it resulted to, where threats to the concept had been eliminated through the lack of biases in pre-testing, better sampling selection process, absence of artificial research settings, and singularity in treatment utilization. Internal validity, as efficacy of control in independent variables was reduced through the Hawthorne effect, where intervention group may be encouraged to modify attitude and behavior due to increased contact with professional facilitators, as compared to control group--the extent of contact may influence amount of information processed and enhanced cooperation for research approvals. 5. Results/Data Analysis 5.1. What differences in outcomes were identified between the intervention and control groups? Specifically, improved knowledge on stroke manifestations and individual response in cerebrovascular emergency were shown to be enhanced, together self monitoring habits on blood pressure elevation and medication compliance, and reduced dietary practices of preservative and saturated fat food consumptions. On the control group, no improvement in such areas was seen, while prescribed physical activity had been significantly decreased, such as walking daily. However, other lifestyle habits had been maintained, including nicotine and alcohol abuse, and high fat diet with fried food. 5.2. What type of data analysis was used? Was this appropriate? Why/why not? In data analysis of collected results, the study utilized the Mann-Whitney U-test. According to Flick (2011), this is a type of statistical analysis which seeks to establish the associations and distinctions between identified variable--such as the educational strategies and learning attitudes and behaviors of participants. This type of test for it assists the study objectives in determining the efficacy of introduced educational strategies, possibly confirming the direct correlation and significance of such learning variables, hence, its appropriateness for the study outcome. 5.3. Using all of the information from your analysis so far, decide whether or not the results of this study should be used to inform clinical practice? The incorporation of behavioral reinforcement in learning appeared to promote better lifestyle attitudes and awareness on recognizing and intercepting stroke conditions. There is enhanced capacity to determine signs of early stroke and active ways in looking for emergency assistance, with more vigilant monitoring of factors for stroke (BP assessment), its medical management (medication adherence), and lifestyle modification that decreases stroke risk factors. It reliability ensures that results are relevant, where external validity of variables assures that it can be easily replicated in different clinical settings. However, its internal reliability is questionable due to increased contact between facilitators and participants, possibly producing false positive development on the capacity of educational strategies as effective way in combating poor compliance in stroke participants. Nonetheless, as literature revealed, such formats in education is more effective for there is increased mutual interaction during planning, implementation, and evaluations phase--where collaboration reinforces learning and its translation to better health attitudes. All in all, the outcomes of the study may have several drawbacks, but its overall concept can be effective in improving the attitude and health conditions of patients who are interested to improve their cerebrovascular status. References Berg, K.E., & Latin, R.W. (2007). Research methods in health, physical education, exercise science, and recreation (3rd ed.). United States of America: Lippincott Williams and Wilkins. Connaway, L.S., & Powell, R.R. (2010). Basic research methods for librarians. United States of America: ABC-CLIO. Flick, U. (2011). Introducing research methodology: a beginner’s guide to doling a research project. Singapore: Sozial Forschung. Houser, J. (2007). Nursing research: reading, using, and creating evidence. United States of America: Jones and Barlett Publishers. Jackson, S.L. (2008). Research methods and statistics: a critical thinking approach. United States of America: WADSWORTH Cengage Learning. Karlsoon, C. Ed. (2008). Researching operations management. New York: Routledge. Sit, J., Yip, V., Ko, S., Gun, A., & Lee, J. (2007). A quasi-experimental study on a community-based stroke prevention programme for clients with minor stroke. Journal of Clinical Nursing, 16, 272-281. Read More