The Practice of Evidence-Based Nursing - Assignment Example

Evidence-Based Practice: Table of Evidence Evidence-Based Nursing: Table of Evidence Introduction Evidence-Based Practice (hereinafter referred to as EBP) is an approach to healthcare provision that is based on a combination of nursing skills and the findings of the most current and relevant studies on the topic(Armolla, Bourgault, & Halm , 2009). EBP puts to practice the most current methods of providing care. Usually, these methods are tested by scrutinizing studies of high quality and testing the major findings of those studies. The goal of EBP is twofold: to improve the quality of care that patients receive in a cost-effective manner. Given its potential to significantly reduce the cost of care provision, EBP has grown in popularity in the last few decades. This paper presents a table of evidence drawn from EBP studies. For each journal article reviewed, it is summarized under the headings shown in the table below. Table of Evidence Title, Journal, Year of publication Type of study Research question/hypothesis Study methodology Level of the study Description of the subjects and sample size Major findings from the study Article 1 Psychodynamic psychotherapy for children and adolescents: a meta-analysis of short-term psychodynamic models Published in the Journal of the American Academy of Child and Adolescent Psychiatry in 2013 The study was a meta-analysis of the short-term models of psychodynamics that have been developed to date. For decades, psychiatrists have used psycho-dynamically-driven interventions to deal with a variety of mental disorders in children and adolescents. However, there had been no meta-analyses to evaluate how effective these therapies are, hence the need for the study (Abbass, Rabung, & Midgley, 2013). After an extensive search, the authors subjected to meta-analysis controlled-outcome studies of brief psychodynamic psychotherapies – those that lasted 40 or fewer sessions. This was a Level A study according to AACN classification: it meta-analyzed several studies in which outcomes were controlled. The meta-analysis involved 11 studies incorporating 655 patients suffering from a wide array of mental disorders. The meta-analysis concluded that STPP may be effective in treating a wide variety of disorders in children and adolescents(Abbass, Rabung, & Midgley, 2013). Article 2 Naturalistic investigation on the efficacy of psycho-oncological interventions in cancer patients and their partners Published in Supportive Care in Cancer in 2013 This was a naturalistic empirical study. This study set out to explore whether POI (psycho-oncological interventions), under natural conditions, in relieving psychopathological symptoms in cancer patients(Barth, Delfino, & Kunzler, 2013). The study involved 186 cancer patients and 117 of their partners at the Oncology and Hematology clinic of a University hospital. ANOVAs were used to analyze temporal change and group effects among people with POI and those without. This was a level B study and AACN’s new categorization of studies (Armolla, Bourgault, & Halm, 2009) The subjects of the study were 186 cancer patients and 117 of their partners. For patients with high levels of distress, it was difficult to conclude of the effectiveness of POI as these patients received additional POI. For moderately stressed patients, POI, as effected in Switzerland, do not improve the well-being of those patients. The study concluded that there was the need for further studies involving more intense POI interventions (Barth, Delfino, &Kunzler, 2013) Article 3 The role of goal adjustment in symptoms of depression, anxiety and fatigue in cancer patients receiving psychosocial care: A longitudinal study Published in Psychological health in 2015 This was a longitudinal study. The study set out to establish whether or not cancer patients showed improvement in their goal adjustment capabilities while receiving psychosocial care(Zhu, Ranchor, Lee, Garssen, &Sanderman, 2015). It further sought to establish whether there was a relationship between those increases and changes in the symptoms of fatigue, anxiety and depression. The study involved 241 cancer patients under psychosocial care at a psycho-oncology facility in the Netherlands. The researchers collected data before the start of the psychosocial care and nine months later. The researchers then used hierarchical regression analysis to analyze the data. This was a level B study and AACN’s new categorization of studies(Armolla, Bourgault, & Halm, 2009). The study involved 241 cancer patients receiving psychosocial care at a psycho-oncological facility in the Netherlands The researchers concluded that enhanced goal reengagement (the ability to free oneself from unrealized goals) was good for the patients’ psychological well-being. Article 4 The long-term effectiveness of the International Child Development Programme (ICDP) implemented as a community-wide parenting programme European Journal of Developmental Psychology Published in 2015 This was a comparative study in which one group of respondents attended the ICDP while the second group did not. Scholars have studied the effectiveness of the International Child Development Programme (ICDP) for the general population in the short-run. This papers aim was to investigate the impact of the programme in the longer run – 6-12 months after the completion of the program (Skar, von Tetzchner, & Clucas, 2015). Questionnaires were administered to both groups on parenting before, upon completion and six to twelve months after the program. The researchers then analyzed the data for changes in score over time. This was a Level C study under AACN’s new categorization. The study was both quantitative and correlational, but lacking randomized controlled trails. The participants of the study were grouped into two. The first group comprised 79 non-clinical caregiver parents whose children attended the ICDP while the second group comprised 62 parents whose children did not attend the programme. The results showed that parents whose children attended the ICDP reported improved scores on parenting and trends towards greater self-efficacy relative to the group whose children did not attend the programme. The attending group also reported fewer feelings of loneliness in parenting. The ICDP group also reported that following the program, their children spent less time watching television and playing video games. The researchers concluded that in order to sustain the initial gains from the ICDP, there ought to be follow-up programs(Skar, von Tetzchner, & Clucas, 2015). Article 5 Trajectories of personal control in cancer patients receiving psychological care Published in Psycho-oncology in 2014 The authors of the paper describe the study as naturalistic. The study had three objectives. First, it sought to group the subjects, who were cancer patients, according clear personal control trajectories while they received psychological care(Zhu, Schroevers, & van der Lee, Trajectories of personal control in cancer patients receiving psychological care, 2014). Secondly, the study sought to examine whether trajectories could be delimited along the lines of clinical and psychological care. Finally, the study sought to differentiate patterns in the various trajectories. The study involved 241 cancer patients under psychological care at the seven psycho-oncological facilities in the Netherlands. Data were collected at three stages: before the start of psychological care, three months after the care had been given and nine months later. The data were then subjected to latent class growth analysis for trends in personal control trajectories. This was a Level C study under AACN’s new categorization. The study was both quantitative and correlational, but lacking randomized controlled trails. The subjects of the study were 241 cancer patients drawn from the seven psycho-oncological facilities in the Netherlands. The results of the study revealed three trajectories of personal control: enduring improvement, temporary improvement and deterioration at 41, 50 and 9%, respectively. The authors concluded that gains in personal control tend to depend on the initial level of control: the higher the control level at the onset, the greater the improvement(Zhu, Schroevers, & van der Lee, Trajectories of personal control in cancer patients receiving psychological care, 2014). Article 6 CAM and energy psychology methods remediate PTSD symptoms in veterans and spouses Published in Explore in 2014 This was a correlational study. A multimodal approach to the application of CAM could have significant benefits to veterans suffering from posttraumatic stress disorder (PTSD) and their families(Church & Brooks, 2014). A total of 218 male veterans and their spouses one of the several retreats that lasted six weeks. They were tested for symptoms of posttraumatic stress disorder (PTSD) before and after the intervention. Participants were tested based on the PTSD checklist on which a score of more than 49 indicates symptoms of PTSD. The study employed Emotional Freedom Techniques among other techniques of energy psychology to look out for PTSD symptoms. At the same time, a number of complementary and alternative (CAM) techniques were used to relieve stress. This was a Level C study under AACN’s new categorization. The study was both quantitative and correlational, but lacking randomized controlled trails. The subjects of the study comprised 219 veterans and their spouses. The veterans reported a mean score of 61.1 while their spouses averaged 42.6. The results confirmed the authors’ hypothesis of the significant role CAM can play in relieving PTSD in veterans and their spouses (Church & Brooks, 2014). The authors also recommended further research to answer some of the questions they had raised in their study. Conclusion These reviews indicate that while many studies have been undertaken that can inform evidence-based practice, many of these studies do not have controlled outcomes. This phenomenon comprises the integrity of such studies to be used as the basis for EBP. The review further reveals that the higher up one goes the AACN’s updated table, the fewer studies there are. In other words, there are much fewer meta-analyses than there are clinical studies that suggest areas for further research. The implication is that much more needs to be done to enlarge the research bank from which EBP can draw (Armolla, Bourgault, & Halm, 2009). References Abbass, A., Rabung, S., & Midgley, N. (2013). Psychodynamic psychotherapy for children and adolescents: a meta-analysis of short-term psychodynamic models. Journal of the American Academy of Child and Adolescent Psychiatry,52.8863-75. Armolla, R., Bourgault, A., & Halm, M. (2009). AACN Levels of Evidence: Whats New? Critical Care Nurse, 29.470-73. Barth, J., Delfino, S., & Kunzler, A. (2013). Naturalistic study on the effectiveness of psycho-oncological interventions in cancer patients and their partners. Supportive Care in Cancer, 21.6 1587-95. Church, D., & Brooks, A. (2014). CAM and energy psychology techniques remediate PTSD symptoms in veterans and spouses. Explore, 10.124-33. Skar, A.-M. S., von Tetzchner, S., & Clucas, C. (2015). The long-term effectiveness of the International Child Development Programme (ICDP) implemented as a community-wide parenting programme. European Journal of Developmental Psychology, 12.154-68. Zhu, L., Ranchor, A., Lee, M., Garssen, B., & Sanderman, R. (2015). The role of goal adjustment in symptoms of depression, anxiety and fatigue in cancer patients receiving psychosocial care: A longitudinal study. Psychological Health , 30.3268-83. Zhu, L., Schroevers, M., & van der Lee, M. (2014). Trajectories of personal control in cancer patients receiving psychological care. Psycho-oncology, 21-32. Read More