According to Gray et al. (2017), there are three guidelines associated with a critical appraisal:

1. Identify the elements or processes of a study.
2. Determine the study’s strengths and weaknesses.
3. Evaluate the credibility, trustworthiness, and meaning of a study. 

These steps can be implemented in quantitative and qualitative research and ensure the examination of the authors’ expertise, the review of the study in its entirety, and determining the usefulness of the findings for practice.

George et al. (2017) explore the effects of mindfulness-based stress reduction practices on chronic pain levels of patients with HIV. Focusing on the first step of a critical appraisal, identifying the processes of a study, I found that participants were English speaking, HIV-infected adults who had been experiencing neuropathic or musculoskeletal pain for at least three months and were recruited from previous studies or referred by their physicians. Thirty-two people enrolled in and completed the study, and they were randomized 1:1 into a control group and MBSR group. The MBSR group received weekly sessions of MBSR content for eight weeks. Likewise, the control group attended weekly sessions on informative and interactive health promotional topics. Efficacy was rated by baseline autonomic function tests and symptom questionnaires by measuring pain intensity, pain interference, symptom burden, perceived stress, and autonomic function effects. 

Strengths in the study by George et al. (2017) include being the first published research regarding MBSR and chronic pain due to HIV. The research was presented in a mixed-methods, randomized, controlled manner. The study’s perceived weaknesses were the small sample size (32) and low participation levels of the people enrolled. 

This study by George et al. (2017) sought to correlate a positive relationship of MBSR practices with HIV-related chronic pain. With this pilot study, the sample size is small, so individual participants’ characteristics may affect outcomes significantly. Three-month follow-up questionnaires and examinations proved to be challenging to acquire through loss of communication with participants. Due to this, the difference in pain intensity observed at three months cannot be considered conclusive. The authors provided preliminary evidence that MBSR is a valuable practice to reduce chronic pain associated with HIV and suggested more studies be performed to support this theory. For future research, Grant et al. (2017) recommended a more tailored MBSR intervention with increased social interaction to maximize attendance.