QUESTIONSTO ADDRESS ON THE BELOW

DISCUSSIONS

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Ask a probing question, substantiated with additional background information, evidence, or research.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

Validate an idea with your own experience and additional research.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

DISCUSSIONS

The topic of this post is outcomes of 6-week cognitive-behavior and mindfulness group intervention in primary care.

Craner, Sawchuk, and Smyth (2016) conducted a study to evaluate the effectiveness of evidence–based cognitive-behavioral and mindfulness–based interventions to treat anxiety and depression in primary care. The sample contained 76 adult primary care patients with concerns about anxiety and depression, giving consent to research participation. Only 54 (65.1%) patients attended at least four sessions, and 29 (34.9%) completed at least one session. The authors chose four-session as a cutoff mark for categorizing patients as participants (Craner, Sawchuk, & Smyth, 2016). Among 54 participants included in the research, 34 were women and 20 men, ranging in age from 20 -88 years. The majority were Caucasian (75.9%) and married (77.8%).

Data sources included self-complete Patient Health Questionnaire 9 (PHQ-9; Kroenke, Siltzer, & Williams, 2001) and Generalized Anxiety Disorder Questionnaire-7 (GAD-7; Spitzer, Kroenke, Williams, & Lowe, 2006). Participants completed these surveys for outcomes measurement at the beginning of each group session. Demographic information was obtained through chart review (Craner, Sawchuk, & Smyth, 2016).

Researchers used the paired-samples t-tests to compare the surveys’ baseline results at the first session and the final results on the last session attended (Craner, Sawchuk, & Smyth, 2016). For depressive symptoms, t (53) = 6.58, p < .001, Cohen’s d = .8, at the end of treatment compared (M = 7.46; SD = 5.92) to baseline (M= 10.09; SD =6.00) (Craner, Sawchuk, & Smyth, 2016). Pre- and post-intervention anxiety symptoms were also evaluated with paired-samples t-test. The results indicate significant decrease in anxiety symptoms, t (453), p <.001, Cohen’s d = .81, upon completion of the treatment group (M = 6.13; SD = 4.30) compared to initial scores (M = 9.44; SD = 4.71) (Craner, Sawchuk, & Smyth, 2016). The researchers used a reliable change score of 5 points to evaluate the clinical significance of symptoms change in both t tests.

The findings of this research suggest that participation in this brief, evidence-based treatment group was associated with significant decreases with large effect sizes for both depressive and anxiety symptoms (Craner, Sawchuk, & Smyth, 2016). Additionally, 65.1% of participants who enrolled in the group completed at least four sessions, which the authors find support for feasibility and acceptability of group treatment in primary care.

The purpose of the study was to evaluate the effectiveness of cognitive–behavioral therapy and mindfulness–based group therapy programs for patients with mood and anxiety disorders within primary care (Craner, Sawchuk, & Smyth, 2016). The study results supported the hypothesis that these interventions can be effective. This study’s value is the successful implementation of the evidence–based treatment principles into a cost-effective model that can be accessible to primary care patients (Craner, Sawchuk, & Smyth, 2016).

Using inferential statistics strengthens the study’s application to evidence-based practice in many ways. First, it allows researchers to decide population parameters based on the statistics from a sample (Polit, 2010, p. 83). In the earlier described study, the authors postulated that the implementations were effective in the small sample, and the results had statistical significance, so this intervention should be effective at any primary care office.

References:

Craner, J. R., Sawchuk, C. N., & Smyth, K. T. (2016). Outcomes of a 6-week cognitive-behavioral and mindfulness group intervention in primary care. Families, Systems & Health: The Journal of Collaborative Family HealthCare, 34(3), 250–259. https://doi-org.ezp.waldenulibrary.org/10.1037/fsh0000202

Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of general internal medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

Polit, D. (2010). Statistics and data analysis for nursing research (2nd ed.). Upper Saddle River, NJ: Pearson Education Inc.

Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of internal medicine, 166(10), 1092–1097. https://doi.org/10.1001/archinte.166.10.1092