Searching and Critiquing Evidence

Question

Bring to mind the various practice problems you and your colleagues have been considering in this course. What insights might the literature provide with regard to these issues? How should you evaluate the research? And, why is it important to review and critique this information?

This Discussion addresses strategies for searching the literature in order to critique existing evidence. Please note that this Discussion is related to Application Assignment #4, which is assigned this week. You are strongly encouraged to read through that assignment now.

To prepare:



•Review the Walden Library Webinars presented in the Learning Resources.



•Recall the practice problem and theoretical framework you identified for the Week 5 Discussion. Using the Walden Library and other professional databases, conduct a search and locate four (4) appropriate primary research articles, one of which is a SYSTEMATIC REVIEW. 

(My practice problem is “Transitional Care Interventions” and the theoretical framework I’m using is Meleis’ Theory of Transition).


•Review the four articles and determine what level of evidence they represent. (Open this link to see list of levels of evidence: http://libguides.winona.edu/c.php?g=11614&p=61584). Using the critique strategies presented in the Learning Resources as a guide, consider how the articles you located either support or weaken the merit of your theoretical framework (Meleis’ Theory of Transition) or the importance of your practice problem which is Transitional Care Interventions.

By Day 3 post a cohesive response that addresses the following:

•How does the literature strengthen or weaken the merit of your selected theoretical framework and practice problem?

•What levels of evidence are most prevalent in these articles?

•Why do you think that level of evidence is most prevalent?

Answer

Searching and Critiquing Evidence

Chiang, L. C., Chen, W. C., Dai, Y. T., & Ho, Y. L. (2012). The effectiveness of telehealth care on caregiver burden, mastery of stress, and family function among family caregivers of heart failure patients: a quasi-experimental study. International journal of nursing studies49(10), 1230-1242.

This article strongly concurs with Melei’s Theory of Transition and the practice problem of Transitional Care Interventions. It evaluates the overall effectiveness of nursing-driven transitional care in conjunction with discharge plans and telehealthcare for patients with chronic diseases. Essentially, this article is centered on establishing the positive outcomes that arise as a result of subjecting eligible patients to the telehealth program and discharging them from the hospital. Results indicate that the family caregivers had significantly lower burdens and better family functions after the intervention. This implies that the concept of transitional care is highly beneficial in advancing quality healthcare to such patients. The level of evidence here is level three (quasi-experimental) primarily because a trial consisting of 63 eligible patients was conducted, thirty of which constitute the experimental group while the rest served as a control. The sample was non-randomized.

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Lerret, S. M. (2009). Discharge readiness: An integrative review focusing on discharge following pediatric hospitalization. Journal for Specialists in Pediatric Nursing14(4), 245-255.

            This article belongs to level one (meta-analysis review) because it provides analysis and infers its conclusion based on thirty eight publications which include both evidence-based research and clinical practice papers.It supportsMelei’s Theory of Transition by reinforcing the role of nurses in enhancing meaningful interactions with patients and building their confidence levels to promote successful transitions from hospitals to homes. Furthermore, it places more emphasis on four concepts, namely support, education, communication and coordination all of which influence discharge readiness in patients and have been drawn from the thirty-eight publications. That is why systematic review is the most prevalent in this article.

Connolly, T. (2014). Post Stroke Survivors’ Experiences of the First Four Weeks During the Transition Directly Home From the Hospital (Doctoral dissertation, Boston College. Graduate School of Arts and Sciences).

The level of evidence here is V (five) (meta-synthesis). The article presents a qualitative descriptive study that seeks to determine the experiences of post-stroke survivors (PSSs) duringthe transition. It supports the practice of Transitional Care Interventionsby reflecting on the importance of transition from hospital to home as a crucial period during which patients make a recovery depending on the interventions made. The study involved 31 participants who were randomly recruited. Also, the analysis was done by qualitative experts and hence meta-synthesis is the dominant level.

Weiss, M., Johnson, N. L., Malin, S., Jerofke, T., Lang, C., & Sherburne, E. (2008). Readiness for discharge in parents of hospitalized children. Journal of pediatric nursing23(4), 282-295.

            Evidence from this article is from cohort studies. The group consists of 135 parents who have hospitalized children and are exposed to the similar risk factors. The study seeks to investigate the readiness for discharge by looking at the quality of discharge teaching advanced to parents. It supports Melei’s theory by setting the platform for transitional care and reinforcing its importance in ensuring full recovery of the patients. According to Tappen (2015), promoting positive outcomes beyond hospitalization solely depends on how well both nurses and parents play their roles in advancing the right conditions for transitional care to prevail and yield the much-expected results.

References

Chiang, L. C., Chen, W. C., Dai, Y. T., & Ho, Y. L. (2012). The effectiveness of telehealth care on caregiver burden, mastery of stress, and family function among family caregivers of heart failure patients: A quasi-experimental study. International journal of nursing studies49(10), 1230-1242.

Connolly, T. (2014). Post Stroke Survivors’ Experiences of the First Four Weeks During the Transition Directly Home From the Hospital (Doctoral dissertation, Boston College. Graduate School of Arts and Sciences).

Lerret, S. M. (2009). Discharge readiness: An integrative review focusing on discharge following pediatric hospitalization. Journal for Specialists in Pediatric Nursing14(4), 245-255.

Tappen, R. M. (2015). Advanced nursing research. London: Jones & Bartlett Publishers.

Weiss, M., Johnson, N. L., Malin, S., Jerofke, T., Lang, C., & Sherburne, E. (2008). Readiness for discharge in parents of hospitalized children. Journal of pediatric nursing23(4), 282-295.

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