Article Critique Paper

Article Critique Paper

Article critique is a profound strategy of appraisal evidence used during nursing research endeavors. In essence, it entails a critical evaluation of a research article to identify its strengths and weaknesses, as well as the article’s applicability in answering clinical questions and informing decisions. Amidst the prevailing challenges of delivering quality and patient-centered care for patients with dementia, incorporating evidence-based practice (EBP) can enable healthcare professionals to use the best available evidence to safeguard patient safety and improve care quality. The purpose of this paper is to present a critique of the article, Feasibility and pilot testing of a mindfulness intervention for frail older adults and individuals with dementia by Kovach et al. (2018).

An Overview of the Selected Article

The selected article is a controlled crossover study conducted by Kovach et al. (2018) to determine the effects of mindfulness intervention in improving health for older adults with multiple chronic conditions and cognitive impairment associated with dementia. Also, the study aimed at comparing the short-and long-term changes in agitation, sleep, stress, and discomfort when participating in a mindfulness intervention and therapeutic cognitive activity program. The researchers introduced participants to various components of the PIN (Present in the Now) meditation programs and cognitive therapeutic activity (COG) for 4 weeks each with a 2-week washout period (Kovach et al., 2018, p. 141). In essence, they used these interventions to test a hypothesis that agitation, negative affect, and cortisol levels would decrease, and sleep would increase after PIN intervention.

The study involved 36 participants from a 160-bed nursing home and a 96-unit apartment that provided independent and assisted living care services. The researchers adhered to the mandatory requirements for nursing research by obtaining approval from an Institutional Review Board and written consent from potential participants. The inclusion criteria for the study included various considerations such as length of stay of ≥4 weeks and an absence of movement disorder that would interfere with actigraphy (Kovach et al., 2018, p. 141). Following an independent data collection process, the researchers used descriptive data analysis strategies such as percentages, means, medians, standard deviations, and ranges to establish the statistical significance of PIN and COG interventions. Further, they used t-tests and ANOVA to analyze variables like agitation, affect, and discomfort. Consequently, the study revealed that mindfulness is feasible for older adults with multiple chronic conditions and cognitive impairment, considering its contribution to strengthening the concept of oneself to promote well-being, comfort, and compassion with negligible known side effects.

Strengths and Weaknesses of the Study

Strengths

The study’s design remains the most profound strength, considering its viability in clinical trials and nursing research. In this sense, the researchers used a controlled crossover design to investigate the feasibility of mindfulness intervention and cognitive therapeutic activity (COG) in improving the health of older adults with dementia. A crossover research design is effective in testing the effectiveness of nursing interventions since it enables researchers to involve participants in multiple interventions at a given time. According to Miranda et al. (2020), this research design provides opportunities for head-to-head trials, meaning participants can receive multiple interventions and can express preferences for or against interventions. As a result, this consideration contributes to the more efficient and accurate statistical comparison between interventions because of the ability to circumvent confounding variables that can occur because of subtle differences between comparison groups.

Another strength of this study is the randomization process that enabled researchers to randomly assign interventions to participants. According to Kovach et al. (2018), participants received a randomized sequence of two study conditions: PIN and cognitive activity (COG) for 4 weeks each with a 2-week washout period (p. 141). Intervention randomization is a strength because it eliminates accidental bias, including selection bias, and provides an opportunity of using probability theory (Lim & In, 2019). The ability to address accidental biases improves a study’s generalizability and applicability in answering clinical questions, as well as testing hypotheses. Finally, the study exhibits another strength by including a washout period between interventions. In essence, a washout period is necessary until the effect of the first intervention subsides (Lim & In, 2021). This period acts as an intermediate phase between two interventions that enable researchers to address the underlying challenge of residual effects (carryover effects) that manifest when the impacts or effects of the previous period’s treatment interventions persist.

Weaknesses

Although the study actualizes many elements of a crossover research design, it exhibits various limitations that provide opportunities for improvement and hinder the study’s validity. The first weakness is the failure to blind data collectors. Kovach et al. (2018) contend that although data collectors were highly objective in assessing different variables, the failure to blind them could have resulted in biased results of the observational measures. According to Monaghan et al. (2021), blinding (masking) entails withholding information that has the potential the influence the study results from one or more parties involved in the research, including participants and data collectors. Although blinding research parties can infringe ethical considerations for nursing research endeavors, it is an essential process for mitigating biases and enhancing the statistical significance of research studies.

Secondly, the research involves a small sample size (36 participants) selected based on strict inclusion criteria. Although a small sample facilitates faster data collection and analysis, it is can prevail as a study limitation. According to Kovach et al. (2018), participants’ low attendance at COG and PIN activities could have influenced the study’s results. Studies with small sample sizes often grapple with the problem of generalizability due to the likelihood of inconclusive and contradictory results. Mostly, a small sample reduces a study’s statistical significance and affects the findings’ generalizability, meaning the research is only applicable in a highly controlled setting.

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Proposed Changes and Recommendations

Although the study’s strengths contribute to its significance in providing the statistical backing for the effectiveness of mindfulness intervention and cognitive therapeutic activities in improving the health of patients with dementia, it is possible to harness its validity and generalizability by intercepting its weaknesses. Notably, the study’s primary weaknesses include the likelihood of biased findings due to the failure to blind data collectors and the statistical effect of a small sample. Firstly, the researcher can improve the study by blinding all parties in the research to address the likelihood of biased results. Monaghan et al. (2021) argue that researchers can conceal and withhold information about study interventions to facilitate the randomization process and reduce biases. In essence, withholding information about interventions can enable research parties like care providers, data collectors, assessors, and trial managers to ensure optimal outcomes that translate to accurate findings.

Also, it is essential to address the problem of a small sample by reviewing inclusion criteria and addressing factors for increased participants’ drop-out during research endeavors. According to Andrade (2020), a larger sample can represent the population and contribute to more accurate findings compared to a small sample. However, researchers should be cautious when recruiting more participants in studies because too large samples are unscientific and unethical because they compromise the research’s statistical significance. Also, extremely large samples can delay data collection and analysis processes, resulting in unplanned inconsistencies and challenges.

Implications of the Study for Nursing Practice

The study provides insights into the rationale for incorporating mindfulness intervention and cognitive therapeutic activities in improving the health of people with dementia. According to Kovach et al. (2018), the researchers involved participants in mindfulness activities that comprised three major components: attention skill exercise, body awareness actions, and compassion medication. These interventions proved effective in addressing dementia-associated variables, including stress, discomfort, and agitation. Although dementia results in detrimental ramifications, including progressive deterioration of cognitive, psychological, and functional disabilities, this study indicates the plausibility of incorporating mindfulness and cognitive therapeutic activities in improving the health of people with multiple chronic conditions. As a result, it provides scholarly explanations and backings for implementing cognitive therapies and meditation in improving patients’ health and enhancing their quality of life.

Conclusion

Healthcare professionals are responsible for implementing evidence-based practices and utilizing scientific knowledge in improving care quality and enhancing patient outcomes. Undeniably, appraising external evidence sources is a prerequisite step for embracing evidence-based practice since it entails assessing sources’ validity, currency, relevance, authority, and purpose in the context of answering clinical questions and improving decisions. By critiquing study articles, it is possible to identify their strengths and weaknesses, as well as their implications for nursing practice. Therefore, article critique is a profound strategy for assessing the suitability of evidence sources in answering clinical questions, solving problems, and enhancing decisions. As a result, this paper critiques the article, Feasibility and pilot trial of a mindfulness intervention for frail older adults and individuals with dementia by identifying its strengths and weaknesses, as well as elaborating on its implication for nursing practice.

 References

Andrade, C. (2020). Sample size and its importance in research. Indian Journal of Psychological Medicine, 42(1), 102–103. https://doi.org/10.4103/ijpsym.ijpsym_504_19

Kovach, C. R., Evans, C.-R., Sattell, L., Rosenau, K., & Gopalakrishnan, S. (2018). Feasibility and pilot testing of a mindfulness intervention for frail older adults and individuals with dementia. Research in Gerontological Nursing, 11(3), 137–150. https://doi.org/10.3928/19404921-20180223-01

Lim, C.-Y., & In, J. (2019). Randomization in clinical studies. Korean Journal of Anesthesiology, 72(3), 221–232. https://doi.org/10.4097/kja.19049

Lim, C.-Y., & In, J. (2021). Considerations for crossover design in a clinical study. Korean Journal of Anesthesiology, 74(4), 293–299. https://doi.org/10.4097/kja.21165

Miranda, J. M., Portocarrero, A. del C. M., Freire, A. L., Abuin, C. M. F., & Saez, A. C. (2020). Advantages, disadvantages, and future trends on the use of the design of experiments in cross-over trials in nutritional clinical investigation. Design of Experiments for Chemical, Pharmaceutical, Food, and Industrial Applications, 158–173. https://doi.org/10.4018/978-1-7998-1518-1.ch007

Monaghan, T. F., Agudelo, C. W., Rahman, S. N., Wein, A. J., Lazar, J. M., Everaert, K., & Dmochowski, R. R. (2021). Blinding in clinical trials: Seeing the big picture. Medicina, 57(7), 1-13. https://doi.org/10.3390/medicina57070647

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Week 10 Assgn 2 Instructions

2: Article Critique
DNP graduates are expected to apply research findings and integrate nursing science into evidence-based practice. To develop your skills in this high level of nursing practice, you will analyze the strengths and weaknesses of a research study over the next several weeks using the concepts presented throughout the course. Your final analysis will be a 5- to 7-page paper that includes the following:

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• A brief, 1- to 2-paragraph overview of the study that you selected.
• An explanation of two to three strengths of the study and support for your selection (i.e., why is this a strength). Be specific.
• An explanation of 2–3 weaknesses of the study and support for your selection (i.e., why is this a weakness). Be specific.
• Note: The strengths and weaknesses that you identified should be in relation to design, sampling, data collection, statistical analysis, results, and discussion of the study that you selected.
• An explanation of proposed changes you would recommend to improve the quality of the study, capitalizing on the strengths and improving on the weaknesses that you identified in the study. Be specific and provide examples.
• A final summary of the implications of this study for nursing practice.
The purpose of the analysis is to help you develop a deeper understanding of the research process, to inspire you to think critically and deeply about research on a specific topic, and to strengthen your ability to integrate research findings into evidence-based nursing practice. This Assignment also gives you practice in analyzing the research literature, which will support you when you begin your DNP project. Before you proceed, please review the rubric for this Assignment.
The Assignment: (5–7 pages)
• Select a research article from the body of literature that you have reviewed related to the practice gap that you have identified and for which you will develop for your DNP Project.
• Review the various quantitative research designs presented in the textbook readings and research articles.
• Consider the research design used in your selected article. Ask yourself the following questions:
o Is the design appropriate for the study? Why or why not?
o Would a different design provide better results? Why or why not?
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting.

Write a 1- to 2-paragraph overview of the study selected.–
Excellent 23 (7.67%) – 25 (8.33%)
The response accurately and completely provides a detailed overview of the research study selected.
Good 20 (6.67%) – 22 (7.33%)
The response accurately provides an overview of the research study selected.
Fair 18 (6%) – 19 (6.33%)
The response inaccurately or vaguely provides an overview of the research study selected.
Poor 0 (0%) – 17 (5.67%)
The response inaccurately and vaguely provides an overview of the research study selected, or it is missing.
Explain two to three strengths of the study and support for your selection. Be specific.

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Explain two to three weaknesses of the study and support for your selection. Be specific.–
Excellent 72 (24%) – 80 (26.67%)
The response accurately and clearly explains in detail two to three strengths of the study.

The response accurately and clearly explains in detail two to three weaknesses of the study.

The response includes relevant, specific, and appropriate examples that fully support the strengths and weaknesses explained.
Good 64 (21.33%) – 71 (23.67%)
The response accurately explains two to three strengths of the study.

The response accurately explains two to three weaknesses of the study.

The response includes relevant, specific, and accurate examples that support the strengths and weaknesses explained.
Fair 56 (18.67%) – 70 (23.33%)
The response inaccurately or vaguely explains two to three strengths of the study.

The response inaccurately or vaguely explains two to three weaknesses of the study.

OR

The response explains <2 strengths and weaknesses.

The response includes inaccurate and irrelevant examples that may support the strengths and weaknesses explained.
Poor 0 (0%) – 55 (18.33%)
The response inaccurately and vaguely explains two to three strengths of the study, or it is missing.

The response inaccurately and vaguely explains two to three weaknesses of the study, or it is missing.

The response includes inaccurate and vague examples that do not support the strengths weaknesses explained, or it is missing.
Explain the proposed changes that you would recommend to improve the quality of the study. Capitalize on the strengths to improve on the weaknesses. Be specific and provide examples.–
Excellent 90 (30%) – 100 (33.33%)
The response comprehensively and fully explains, in detail, the proposed recommended changes to improve the quality of the study.

The response accurately and clearly analyzes, in detail, the strengths of the study, in the proposed changes, to capitalize on these strengths.

The response includes relevant, specific, and appropriate examples to fully support the proposed changes.
Good 80 (26.67%) – 89 (29.67%)
The response explains the proposed recommended changes to improve the quality of the study.

The response analyzes the strengths of the study, in the proposed changes, to capitalize on these strengths.

The response includes relevant, specific, and accurate examples that support the proposed changes.
Fair 70 (23.33%) – 79 (26.33%)
The response inaccurately or vaguely explains the proposed recommended changes to improve the quality of the study.

The response inaccurately or vaguely analyzes the strengths of the study, in the proposed changes, and may capitalize on these strengths.

The response includes inaccurate and irrelevant examples that may support the proposed changes.
Poor 0 (0%) – 69 (23%)
The response inaccurately and vaguely explains the proposed recommended changes to improve the quality of the study, or it is missing.

The response inaccurately and vaguely analyzes the strengths of the study, in the proposed changes, and does not capitalize on these strengths, or it is missing.

The response includes inaccurate and vague examples that do not support the proposed changes, or it is missing.
Write a final summary of the implications of this study for nursing practice.–
Excellent 45 (15%) – 50 (16.67%)
The response accurately and clearly summarizes, in detail, the implications of this study for nursing practice.

The response includes relevant, specific, and appropriate examples that fully support the summarized implications.
Good 40 (13.33%) – 44 (14.67%)
The response accurately summarizes the implications of this study for nursing practice.

The response includes relevant, specific, and accurate examples that support the summarized implications.
Fair 35 (11.67%) – 39 (13%)
The response inaccurately or vaguely summarizes the implications of this study for nursing practice.

The response includes inaccurate and irrelevant examples that may support the summarized implications.
Poor 0 (0%) – 34 (11.33%)
The response inaccurately and vaguely summarizes the implications of this study for nursing practice, or it is missing.

The response includes inaccurate and vague examples that do not support the summarized implications, or it is missing.
Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.–
Excellent 15 (5%) – 15 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion is provided which delineates all required criteria.
Good 12 (4%) – 12 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment is stated, yet is brief and not descriptive.
Fair 10.5 (3.5%) – 10.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

Purpose, introduction, and conclusion of the assignment is vague or off topic.
Poor 0 (0%) – 10 (3.33%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.

No purpose statement, introduction, or conclusion was provided.
Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation–
Excellent 15 (5%) – 15 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
Good 12 (4%) – 12 (4%)
Contains a few (1 or 2) grammar, spelling, and punctuation errors.
Fair 10.5 (3.5%) – 10.5 (3.5%)
Contains several (3 or 4) grammar, spelling, and punctuation errors.
Poor 0 (0%) – 10 (3.33%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.–
Excellent 15 (5%) – 15 (5%)
Uses correct APA format with no errors.
Good 12 (4%) – 12 (4%)
Contains a few (1 or 2) APA format errors.
Fair 10.5 (3.5%) – 10.5 (3.5%)
Contains several (3 or 4) APA format errors.
Poor 0 (0%) – 10 (3.33%)
Contains many (≥ 5) APA format errors.
LEARNING RESOURCES:

https://search.proquest.com/scholarly-journals/employing-qualitative-description-approach-health/docview/2423778952/se-2?accountid=14872
https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.1177%2F1744987119880234
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225027/
https://go.openathens.net/redirector/waldenu.edu?url=https://dx.doi.org/10.4135/9781412984287
https://go.openathens.net/redirector/waldenu.edu?url=https://doi.org/10.1111/jonm.13123
https://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=129343920&site=ehost-live&scope=site&authtype=shib&custid=s6527200

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