Benchmark- Research Critique and Picot Statement Final Draft

Benchmark- Research Critique and Picot Statement Final Draft
Running head: LITERATURE SEARCH 1 Picot Statement and Literature Search Your Name: Idalmis Espinosa Institution: Grand Canyon University Course: NRS-433V Introduction to Nursing Research Date: 05/03/17 Literature Search Practice Problem/Issue and PICOT Question Hypertension contributes to the death of many people throughout the world, yet there is still poor management of the condition. Establishing effective control measures could significantly help to control the number of deaths worldwide. To control and management hypertension effectively, it is important to identify and manage the lifestyle risk factors associated with the condition as that helps to lower blood pressure. In addition, it is vital to perform regular screening, communicating effectively with patients, monitoring patients on a regular basis, and adhering to treatment. In particular, it is possible to prevent and control the condition quite effectively through lifestyle changes (diet and regularly engaging in exercise) as these help to significantly regulate blood pressure. PICOT Question For male adults between the ages of 40 and 70 with hypertension, and with multiple co-morbidities (P), will the change in lifestyle (engaging regularly in exercise and eating healthier and balanced meals) (I), compared to patients who use medication to treat/manage their hypertension (C), help to regulate their blood pressure and reduce the risk of developing cardiovascular diseases (O) in their recovery period within 6 months (T). References Dua, S., Bhuker, M., Sharma, P., Dhall, M., & Kapoor, S. (2014). Body Mass Index Relates to Blood Pressure Among Adults. North American Journal of Medical Sciences, 6(2), 89–95. http://doi.org/10.4103/1947-2714.127751 Background: The blood pressure and anthropometric measurements are important for evaluating the health of children, adolescents as well as adults. Aim: The aim is to study the blood pressure and body dimensions and to find out the prevalence of overweight/obesity and hypertension among adults. Materials and Methods: A cross-sectional study was conducted of all the people belonging to the Punjabi community, residing in Roshanara area and Jaina building in Delhi, for the past 20 years and aged 18-50 years. The men were engaged in transport business and women were mainly housewives. Results: Mean values of all the measurements, that is, height, weight, upper arm circumference, pulse rate, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were higher among males as compared with females, except skinfold thicknesses. Body mass index (BMI) and fat percentage was found to be higher among females as compared with males. There was a significant positive correlation between BMI, fat percentage, and blood pressure both SBP as well as DBP. Odds ratio showed that overweight/obese subjects were more likely to have hypertension than those with normal BMI. Conclusion: Prevalence of prehypertension among overweight/obese suggested an early clinical detection of prehypertension and intervention including life style modification, particularly weight management. Howes, F., Warnecke, E., &Nelson, M. (2013). Barriers to lifestyle risk factor assessment and management in hypertension: A qualitative study of Australian general practitioners. Journal of Human Hypertension, 27, 474-478 doi:10.1038/jhh.2013.9 Hypertension is a leading cause of mortality and disease burden worldwide, yet its management remains suboptimal. Identification and management of lifestyle risk factors should be a clinical priority in all patients because of the beneficial effects of lifestyle intervention on blood pressure. The objective of this qualitative focus group study was to identify barriers to lifestyle management in hypertension in Australian general practice. Purposeful sampling was used to select large group practices. Six focus groups (n=30) were audio recorded and transcribed. An iterative thematic analysis was conducted. Overall participants felt they had the required knowledge to provide broad lifestyle advice. However, cynicism dominated due to an overwhelming lack of success in practice. Patient reluctance and ambivalence were identified as major barriers but participants were willing to share the responsibility. Other barriers included time, reduced access to allied health and broader determinants of health. General practitioners need to be empowered to allow continuation of valuable lifestyle advice and counselling. The results emphasise the importance of ongoing lifestyle assessment and tailoring of management to the complex interplay of factors that impact on a patient’s ability to adopt and maintain lifestyle change. System issues need to be addressed to provide better streamlined care.  Legido-Quigley H, Camacho Lopez PA, Balabanova D, Perel P, Lopez-Jaramillo P, Nieuwlaat R, et al. (2015) Patients’ knowledge, attitudes, behaviour and health care experiences on the prevention, detection, management and control of hypertension in Colombia: A qualitative study. PLoS ONE 10(4): e0122112. https://doi.org/10.1371/journal.pone.0122112 Abstract Hypertension is a leading cause of premature death worldwide and the most important modifiable risk factor for cardiovascular disease. Effective screening programs, communication with patients, regular monitoring, and adherence to treatment are essential to successful management but may be challenging in health systems facing resource constraints. This qualitative study explored patients’ knowledge, attitudes, behaviour and health care seeking experiences in relation to detection, treatment and control of hypertension in Colombia. We conducted in-depth interviews and focus group discussions with 26 individuals with hypertension and 4 family members in two regions. Few participants were aware of ways to prevent high blood pressure. Once diagnosed, most reported taking medication but had little information about their condition and had a poor understanding of their treatment regime. The desire for good communication and a trusting relationship with the doctor emerged as key themes in promoting adherence to medication and regular attendance at medical appointments. Barriers to accessing treatment included co-payments for medication; costs of transport to health care facilities; unavailability of drugs; and poor access to specialist care. Some patients overcame these barriers with support from social networks, family members and neighbours. However, those who lacked such support, experienced loneliness and struggled to access health care services. The health insurance scheme was frequently described as administratively confusing and those accessing the state subsidized system believed that the treatment was inferior to that provided under the compulsory contributory system. Measures that should be addressed to improve hypertension management in Colombia include better communication between health care professionals and patients, measures to improve understanding of the importance of adherence to treatment, reduction of co-payments and transport costs, and easier access to care, especially in rural areas. Rao, C. R., Kamath, V. G., Shetty, A., & Kamath, A. (2013). High blood pressure prevalence and significant correlates: A quantitative analysis from Coastal Karnataka, India. ISRN Preventive Medicine, doi:10.5402/2013/574973 Abstract Hypertension is a premier risk factor for cardiovascular disease which can be recognized if sought and treated effectively. Effective management of high blood pressure is possible when the magnitude of the problem is identified. So, a cross-sectional community based survey among 1,239 respondents aged ≥30 years was designed to estimate the prevalence and the sociodemographic correlates of hypertension among adults aged ≥30 years. Data was collected by personal interviews, followed by anthropometric and blood pressure measurements. Analysis was done using Statistical Package for the Social Sciences (SPSS) version 11.5. The prevalence of hypertension was 43.3%, with the prevalence being more among males (51.6%) as compared to females (38.9%). Of the total prevalence 23.1% (287) were known cases, and 20.2% (250) were newly detected cases. Based on the seventh report of the Joint National Committee (JNC VII) on high blood pressure, prehypertension was noted among 38.7%. Advancing age, male gender, current diabetic status, central obesity, overweight and obesity as defined by body mass index, and family history of hypertension were identified as significant correlates for hypertension by multivariate logistic regression. Shima, R., Farizah, M. H., & Majid, H. A. (2014). A qualitative study on hypertensive care behavior in primary health care settings in Malaysia. Patient Preference and Adherence, 8, 1597–1609. http://doi.org/10.2147/PPA.S69680 Abstract Purpose: The aim of this study was to explore patients’ experiences with their illnesses and the reasons which influenced them in not following hypertensive care recommendations (antihypertensive medication intake, physical activity, and diet changes) in primary health clinic settings. Patients and methods: A qualitative methodology was applied. The data were gathered from in-depth interviews with 25 hypertensive patients attending follow-up in nine government primary health clinics in two districts (Hulu Langat and Klang) in the state of Selangor, Malaysia. The transcribed data were analyzed using thematic analysis. Results: There was evidence of lack of patient self-empowerment and community support in Malaysian society. Most of the participants did not take their antihypertensive medication or change their physical activity and diet after diagnosis. There was an agreement between the patients and the health care professionals before starting the treatment recommendation, but there lacked further counseling and monitoring. Most of the reasons given for not taking antihypertensive medication, not doing physical activity and not following diet recommendations were due to side effects or fear of the side effects of antihypertensive medication, patients’ attitudes, lack of information from health care professionals and insufficient social support from their surrounding environment. We also observed the differences on these reasons for nonadherence among the three ethnic groups. Conclusion: Health care professionals should move toward supporting adherence in the management of hypertensive patients by maintaining a dialogue. Patients need to be given time to enable them to overcome their inhibition of asking questions and to accept the recommendations. A self-management approach must be responsive to the needs of individuals, ethnicities, and communities. Tong, X., Taylor, A. W., Giles, L., Wittert, G. A., Shi, Z. (2014). Tea consumption is inversely related to 5-year blood pressure change among adults in Jiangsu, China: A cross-sectional study. Nutrition Journal, 13(98). doi: 10.1186/1475-2891-13-98. Abstract Background: Data relating to the association between tea consumption and blood pressure change are inconsistent. The aim of this analysis was to investigate the association between tea consumption and the change in blood pressure (BP) in Chinese adults over a 5-year period. Methods: Data from 1109 Chinese men (N= 472) and women (N= 637) who participated in the Jiangsu Nutrition Study (JIN) were analysed. BP was measured in 2002 and 2007. Tea (green, black and total tea) consumption was quantitatively assessed at the follow-up survey in 2007. Results: Total tea and green tea consumption were inversely associated with 5-year diastolic BP (DBP) but not systolic BP (SBP) change. In the multivariable analysis, compared with no consumption of tea, those with daily total tea/green tea consumption of at least10 g had 2.41 mmHg and 3.68 mmHg smaller increase of DBP respectively. There was a significant interaction between smoking and total tea/green tea consumption and DBP change. The inverse association between total tea/green tea consumption and DBP change was significant only in non-smokers. Green tea consumption was inversely associated with SBP change only in non-smokers and those without central obesity. Conclusion: The consumption of green tea is inversely associated with 5-year BP change among Chinese adults, an effect abrogated by smoking.
Benchmark- Research Critique and Picot Statement Final Draft
Running head: QUALITATIVE ARTICLE CRITIQUE 1 Qualitative Article Critique Your Name: Idalmis Espinosa Institution: Grand Canyon University Course: NRS-433V Introduction to Nursing Research Date: 05/05/17 Qualitative Article Critique Summary of Article Topic In “A qualitative study on hypertensive care behavior in primary health care settings in Malaysia” Shima, Farizah, and Majid (2014) explore the issue of hypertension. In particular, the study conducted in Malaysia focused on understanding the behavior of hypertensive patients in primary healthcare facilities. In this qualitative study, the authors seek to understand patients’ experiences with their health conditions as well as explore the various reasons that cause them not to adhere to the recommended care plans. Some of the hypertensive care recommendations usually include diet changes, physical activity, and antihypertensive medication intake (Burns & Grove, 2011). Background of Study Hypertension, a condition associated with abnormally high blood pressure, is responsible for the loss of many lives throughout the world each year. It is possible for a person to have a high blood pressure without being aware of it because its signs and symptoms are not easily noticeable. With proper management of the condition, it is possible to avert fatalities associated with the condition. In addition, early diagnosis and regular health checkups can greatly help to promote proper management. To control and manage hypertension effectively, it is important to identify and manage the lifestyle risk factors associated with the condition as that helps to lower blood pressure, thereby significantly improving health outcomes. This study aimed to study the experiences of patients with hypertension and to establish the reasons that cause them not to adhere to the recommended care plans (which include diet changes, taking medication for hypertension, and engaging in exercises) in primary healthcare facilities. The reader should care about this study because in most cases hypertension does not have noticeable symptoms. However, with early diagnosis, it is possible to manage it effectively and to avert possible fatalities from the condition. Of the known hypertensive patients in Malaysia, 78.4 percent of them stated that they were on oral antihypertensive medications. Having a high number of people on medication significantly increases the overall cost of health care in a country such as Malaysia. Shima, Farizah, and Majid (2014) have not explicitly provide the questions for this study; nevertheless, it is possible to infer the questions from the answers. In this case, the researchers aimed to find out how the participants think and feel with regard to their behavior and their medications as far as their hypertensive conditions are concerned. I consider the purpose and research questions of this study to be well related. Method of Study Shima, Farizah, and Majid (2014) used in-depth interviews, which involved 25 with hypertension who were attached to 9 government primary healthcare facilities in 2 districts (Klang and Hulu Langat). I consider that method to be quite fitting for this study. The authors analyzed the transcribed data using thematic analysis, which is also a reliable and suitable method for analysis. The authors do not identify a specific perspective from which they developed the study. The authors mainly included journals in the study. Most of the journal articles were qualitative in nature while a few of them were quantitative in nature. The authors also included books and credible websites, which helped to improve the quality of research and information available on this topic. More than half of the articles that the authors cited in this study were more than five years old from the date of publication of this study. Nevertheless, the authors ensured to use only relevant sources for their study. Shima, Farizah, and Majid (2014) have not expressly indicated any weaknesses with the studies that they used in their research. The authors have provided an in-depth literature review, which explores many aspects of hypertension, which enables the reader to get a better understanding of this health condition. There was no framework or diagram developed from the findings of this study. Results of Study This study reveals that there are sufficient facts indicating lack of community support and empowerment of patients the Malaysian society. It is also evident that most of the participants failed to adhere to the recommended lifestyle changes (such and changes in diet and engaging more in physical activity) and most of them also failed to take their antihypertensive medication after diagnosis. In addition, the findings reveal that the health care professionals and patients entered into some form of agreement before commencement of the treatment recommendation; however, there was no follow-up monitoring and counseling. Some of the reasons that most patients gave for failing to engage in physical activity, failing to take their antihypertensive medication, and not adhering to diet recommendations include inadequate information from healthcare professionals, patients’ attitudes, side effects of the hypertension medication, fear of those side effects, and inadequate social support from their immediate environments (Shima, Farizah, and Majid, 2014). These findings have profound implications to nursing because it means that health care professionals can then take corrective action to ensure better adherence to the care recommendation plans that they devise for their patients, thereby significantly helping to boost health outcomes. These findings contribute to nursing knowledge in the sense that they help to identify the thoughts and feelings of hypertensive patients and the possible measures that they can take to control the situation. The findings are quite significant because they have impact on all areas of nursing including administration, education, and practice. Ethical Considerations Shima, Farizah, and Majid (2014) ensured to obtain ethical approval for their study, which they got from the University Malaya Medical Ethics Committee. The Malaysian Ministry of Health (National Medical Research Register number 12-625-12500) also approved the study. More importantly, the researchers ensured the confidentiality of the participants during the interviews and in any other engagements during the research. In this case, the interviewer ensured exclusivity of the answers by conducting the interviews only in the presence of the interviewee.  The interviewer conducted the in-depth interviews face-to-face and in a secluded location in the healthcare facility. This happened after the subjects had completed their sessions with caregivers and had taken their medication.  Conclusion This study shows that health care professionals should take a more proactive role in supporting their hypertensive patients to adhere to the care recommendation plans provided for them. In their study, Shima, Farizah, and Majid (2014) show that health care professionals can use dialogue to facilitate management among hypertensive patients. In addition, health care professionals should give hypertensive patients sufficient time to accept the recommendations and to overcome their shyness of asking questions (Burns & Grove, 2011). Essentially, a self-management approach should be helpful in facilitating better healthcare for individuals, communities, and ethnicities. References Burns, N., & Grove, S. (2011).Understanding nursing research (5thed.). St. Louis, MO: Elsevier. Shima, R., Farizah, M. H., & Majid, H. A. (2014). A qualitative study on hypertensive care behavior in primary health care settings in Malaysia. Patient Preference and Adherence, 8, 1597–1609. Retrieved from http://doi.org/10.2147/PPA.S69680
Benchmark- Research Critique and Picot Statement Final Draft
Running head: QUANTITATIVE ARTICLE CRITIQUE 1 Quantitative Article Critique Name: Idalmis Espinosa Institution: Grand Canyon University Course: NRS-433V Introduction to Nursing Research Date: 05/06/17 Quantitative Article Critique Summary of Article Topic In “Tea consumption is inversely related to 5-year blood pressure change among adults in Jiangsu, China: A cross-sectional study,” Tong, Taylor, Giles, Wittert, and Shi (2014) set out to the impact that tea consumption has on blood pressure change. In this particular study, the authors performed their study among adults in Jiangsu, China over a period of five years. High blood pressure (also known as hypertension) does not usually present any symptoms and it contributes to the death of many people throughout the world. There is need to find effective ways of managing the condition to save lives. Proper identification and management of the lifestyle risk factors associated with hypertension could significantly help to lower blood pressure (Burns & Grove, 2011). Background of the Study As noted, high blood pressure contributes to the deaths of many people throughout the world and there is therefore need to ensure proper management of the condition. Health care experts should devise effective interventions to ensure effective control of the condition. Making some lifestyle adjustments (diet changes and participating regularly in physical activity) could help in managing the risk factors associated with the condition as that helps to lower blood pressure. More importantly, individuals should ensure to perform regular screening and adhering to treatment. Caregivers should also ensure to communicate effectively with patients as well as to monitor them on a regular basis. In this case, the researchers noted that there was inconsistent data with regard to the connection between the consumption of tea and change in blood pressure (Tong, Taylor, Giles, Wittert & Shi, 2014). The main purpose of undertaking this study was to explore how consumption of tea causes change in BP among Chinese adult population over a 5-year period. Readers should care about this study because hypertension is a condition that is fatal and does not usually present any signs and symptoms in most cases. In addition, readers should note that hypertension contributes to a host of health complications such as loss of vision, kidney disease, stroke, and diabetes, heart complications/failure, and peripheral vascular disease, among others. Therefore, hypertensive patients should strive to manage their conditions to avert the risks associated with the condition, most of which are not only expensive to treat, but also quite fatal. The authors have not explicitly provided the questions for this research, but they were focused on finding out the quantity of tea that the participants consume each week and the effect that such consumption has on their blood pressure. In my view, the research questions are related to the purpose that the researchers have for this study. Method of Study The benefit of participating in this study is that the participants get an opportunity to check their health status as far as hypertension is concerned and getting into a program that will enable them to know how to effectively control and manage their hypertension through diet (in this case, the consumption of tea). According to Tong, Taylor, Giles, Wittert, and Shi (2014), tea is helpful in controlling hypertension because it contains numerous chemical substances and antioxidants (such as flavonoids, phenolic acids, polyphenols, caffeine, theanine, and theophylline) that contribute to inflammation and diabetes. The authors indicate that they ensured to obtain informed and written consent from all their subjects in that study. It seems that the subjects participated voluntarily in this study because the health workers interviewed them in their homes with a standard questionnaire. The researchers conducted this study as per the guidelines set by the Declaration of Helsinki. Besides, the Jiangsu Provincial Centre for Disease Control and Prevention approved all the procedures/methods that the researchers used in the study. Tea consumption was a continuous variable in this study. Other variables include smoking, diastolic blood pressure and systolic blood pressure. Qualified caregivers used a standard questionnaire to collect the data through interviews at the homes of the participants. The researchers validated this data collection method by stating that it is useful for collecting face-to-face interview information. The data was collected from 1109 Chinese men and 637 Chinese women between 2002 and 2007. The researchers collected the information for their research over a five-year period. The analysis of data relating to food consumption was completed using the Chinese Food Composition Table and STATA 12 was used to perform all the analyses. There is no information explaining how the researchers maintained rigor of their study. The study also used ANOVA to compare differences of continuous variables. To limit information bias, the study involved intensively trained health workers in the data collection and management work. Results of the Study Findings of this study show that there was an inverse/converse association between total tea consumption with the diastolic blood pressure (DBP) over a 5-year period, but there was no systolic blood pressure (SBP) change. The multivariable analysis indicated that those who consumed daily total tea at a minimum of 10g had 2.41-mmHg while those who did not had 3.68-mmHg smaller increase (Tong, Taylor, Giles, Wittert & Shi, 2014). I think the findings that the researchers have for this study present an accurate manifestation of the reality and so I think that in the findings of the research are credible. One major limitation noted in this study is that there was omission in the collection of the baseline for tea consumption in 2002. In addition, follow-up was difficult to maintain because of the somewhat high attrition rate of loss. There was coherent logic presentation of the findings, which are quite valuable especially in nursing practice and education. The researchers have not made any suggestions for further research. Ethical Considerations The researchers conducted this study as per the guidelines set by the Declaration of Helsinki. In addition, the Jiangsu Provincial Centre for Disease Control and Prevention approved all the methods used in this study (Tong, Taylor, Giles, Wittert & Shi, 2014). The study does not explicitly mention about patient protection, but from the manner in which the researchers interacted with the participants suggests that there was protection of their privacy. There was ethical consideration of the participants regarding their treatment. Conclusion This investigation shows that the drinking green tea has a converse association with change of blood pressure among Chinese adults over a 5-year period. This study is important because it shows that caregivers can significantly control and manage hypertension through diet, and in particular, the consumption of tea in lowering the blood pressure in patients with the condition (Tong, Taylor, Giles, Wittert & Shi, 2014). By implementing this intervention, caregivers would be able to help many hypertensive patients to manage their health conditions more effectively (Burns & Grove, 2011). References Burns, N., & Grove, S. (2011).Understanding nursing research (5thed.). St. Louis, MO: Elsevier. Tong, X., Taylor, A. W., Giles, L., Wittert, G. A., Shi, Z. (2014). Tea consumption is inversely related to 5-year blood pressure change among adults in Jiangsu, China: A cross-sectional study. Nutrition Journal,13(98). Retrieved from 10.1186/1475-2891-13-98.
Benchmark- Research Critique and Picot Statement Final Draft
Research Critique Guidelines To write a critical appraisal that demonstrates comprehension of the research study conducted, address each component below for qualitative study in the Topic 2 assignment and the quantitative study in the Topic 3 assignment. Successful completion of this assignment requires that you provide a rationale, include examples, or reference content from the study in your responses. Qualitative Study Background of Study: Identify the clinical problem and research problem that led to the study. What was not known about the clinical problem that, if understood, could be used to improve health care delivery or patient outcomes? This gap in knowledge is the research problem. How did the author establish the significance of the study? In other words, why should the reader care about this study? Look for statements about human suffering, costs of treatment, or the number of people affected by the clinical problem. Identify the purpose of the study. An author may clearly state the purpose of the study or may describe the purpose as the study goals, objectives, or aims. List research questions that the study was designed to answer. If the author does not explicitly provide the questions, attempt to infer the questions from the answers. Were the purpose and research questions related to the problem? Method of Study: Were qualitative methods appropriate to answer the research questions? Did the author identify a specific perspective from which the study was developed? If so, what was it? Did the author cite quantitative and qualitative studies relevant to the focus of the study? What other types of literature did the author include? Are the references current? For qualitative studies, the author may have included studies older than the 5-year limit typically used for quantitative studies. Findings of older qualitative studies may be relevant to a qualitative study. Did the author evaluate or indicate the weaknesses of the available studies? Did the literature review include adequate information to build a logical argument? When a researcher uses the grounded theory method of qualitative inquiry, the researcher may develop a framework or diagram as part of the findings of the study. Was a framework developed from the study findings? Results of Study What were the study findings? What are the implications to nursing? Explain how the findings contribute to nursing knowledge/science. Would this impact practice, education, administration, or all areas of nursing? Ethical Considerations Was the study approved by an Institutional Review Board? Was patient privacy protected? Were there ethical considerations regarding the treatment or lack of? Conclusion Emphasize the importance and congruity of the thesis statement. Provide a logical wrap-up to bring the appraisal to completion and to leave a lasting impression and take-away points useful in nursing practice. Incorporate a critical appraisal and a brief analysis of the utility and applicability of the findings to nursing practice. Integrate a summary of the knowledge learned. Quantitative Study Background of Study: Identify the clinical problem and research problem that led to the study. What was not known about the clinical problem that, if understood, could be used to improve health care delivery or patient outcomes? This gap in knowledge is the research problem. How did the author establish the significance of the study? In other words, why should the reader care about this study? Look for statements about human suffering, costs of treatment, or the number of people affected by the clinical problem. Identify the purpose of the study. An author may clearly state the purpose of the study or may describe the purpose as the study goals, objectives, or aims. List research questions that the study was designed to answer. If the author does not explicitly provide the questions, attempt to infer the questions from the answers. Were the purpose and research questions related to the problem? Methods of Study Identify the benefits and risks of participation addressed by the authors. Were there benefits or risks the authors do not identify? Was informed consent obtained from the subjects or participants? Did it seem that the subjects participated voluntarily in the study? Was institutional review board approval obtained from the agency in which the study was conducted? Are the major variables (independent and dependent variables) identified and defined? What were these variables? How were data collected in this study? What rationale did the author provide for using this data collection method? Identify the time period for data collection of the study. Describe the sequence of data collection events for a participant. Describe the data management and analysis methods used in the study. Did the author discuss how the rigor of the process was assured? For example, does the author describe maintaining a paper trail of critical decisions that were made during the analysis of the data? Was statistical software used to ensure accuracy of the analysis? What measures were used to minimize the effects of researcher bias (their experiences and perspectives)? For example, did two researchers independently analyze the data and compare their analyses? Results of Study What is the researcher’s interpretation of findings? Are the findings valid or an accurate reflection of reality? Do you have confidence in the findings? What limitations of the study were identified by researchers? Was there a coherent logic to the presentation of findings? What implications do the findings have for nursing practice? For example, can the findings of the study be applied to general nursing practice, to a specific population, or to a specific area of nursing? What suggestions are made for further studies? Ethical Considerations Was the study approved by an Institutional Review Board? Was patient privacy protected? Were there ethical considerations regarding the treatment or lack of? Conclusion Emphasize the importance and congruity of the thesis statement. Provide a logical wrap-up to bring the appraisal to completion and to leave a lasting impression and take-away points useful in nursing practice. Incorporate a critical appraisal and a brief analysis of the utility and applicability of the findings to nursing practice. Integrate a summary of the knowledge learned. Reference Burns, N., & Grove, S. (2011). Understanding nursing research (5th ed.). St. Louis, MO: Elsevier. © 2016. Grand Canyon University. All Rights Reserved.