Quantitative Critical Appraisal – 4 pages

Write a critical appraisal that demonstrates comprehension of two quantitative research studies. Use the “Research Critique Guidelines – Part II” document to organize your essay. Successful completion of this assignment requires that you provide a rationale, include examples, and reference content from the study in your responses.

Use the practice problem and two quantitative, peer-reviewed research articles you identified in the Topic 1 assignment to complete this assignment.

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In a 1,000–1,250 word essay, summarize two quantitative studies, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

APA Formatno copyingNo Plagiarism

ResearchCritique Guidelines – Part II

Use this document to organize your essay. Successful completion of this assignment requires that you provide a rationale, include examples, and reference content from the studies in your responses.

Quantitative Studies

Background

1. Summary of studies. Include problem, significance to nursing, purpose, objective, and research question.

How do these two articles support the nurse practice issue you chose?

1. Discuss how these two articles will be used to answer your PICOT question.

2

. Describe how the interventions and comparison groups in the articles compare to those identified in your PICOT question.

Method of Study:

1. State the methods of the two articles you are comparing and describe how they are different.

2. Consider the methods you identified in your chosen articles and state one benefit and one limitation of each method.

Results of Study

1. Summarize the key findings of each study in one or two comprehensive paragraphs.

2.

What are the implications of the two studies you chose in nursing practice?

Outcomes Comparison

1. What are the anticipated outcomes for your PICOT question?

2. How do the outcomes of your chosen articles compare to your anticipated outcomes?

© 2019. Grand Canyon University. All Rights Reserved.

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LiteratureEvaluation Table

Student Name: Benadeth Geoffrey

Summary of Clinical Issue (

2

00-250 words): Child obesity is a medical condition that affects both teenagers and children, resulting in having too much fat stored within the body and negatively affecting the child. It is a public pandemic that is taken with too much consideration, and it has got to affect a lot of children around the globe. There are many factors that contribute to childhood obesity in America. One of the key things is that only 2% of children in America get healthy foods. That means that 2% or less consume a well-balanced diet while 98% or more children do not receive proper nutrition. Obesity in children contributes to reduced life expectancy, and there is a need to develop better eating habits among the children to rescue cases of the chronic trend. Another thing is that obesity can develop due to a lack of physical activity whereby one out of the four children does not get to exercise often enough. The other thing is that most of the children sometimes watch television for about four to five hours a day, which contributes to gaining weight. Lastly, children’s foods also contribute a lot to gaining weight by most children. All these factors have contributed to childhood obesity being a significant problem in the current society.

PICOT Question: Does parental nutritional and exercise behavior have a greater effect on childhood obesity when compared to behaviors that kids are exposed to outside of the home?

Criteria

Article 1

Article 2

Article 3

APA-Formatted Article Citation with Permalink

Marsh, S., Taylor, R., Galland, B., Gerritsen, S., Parag, V., & Maddison, R. (2020). Results of the 3 Pillars Study (3PS), a relationship-based programme targeting parent-child interactions, healthy lifestyle behaviours, and the home environment in parents of preschool-aged children: A pilot randomised controlled trial. PLoS ONE, 15(9), 1–16. https://doi-org.lopes.idm.oclc.org/10.1371/journal.pone.0238977

Laura Otterbach, Noereem Z. Mena, Geoffrey Greene, Colleen A. Redding, Annie De Groot, & Alison Tovar. (2018). Community-based childhood obesity prevention intervention for parents improves health behaviors and food parenting practices among Hispanic, low-income parents. BMC Obesity, 5(1), 1–10. https://doi-org.lopes.idm.oclc.org/10.1186/s40608-018-0188-2

Luesse, H. B., Paul, R., Gray, H. L., Koch, P., Contento, I., & Marsick, V. (2018). Challenges and Facilitators to Promoting a Healthy Food Environment and Communicating Effectively with Parents to Improve Food Behaviors of School Children. Maternal & Child Health Journal, 22(7), 958–967. https://doi-org.lopes.idm.oclc.org/10.1007/s10995-018-2472-7

How Does the Article Relate to the PICOT Question?

This article reported on an intervention created to help parents promote healthy nutritional behaviors at home.

This article looked at parental feeding behaviors in the Hispanic population and investigated the link between childhood obesity.

This article looked at barriers to parents promoting healthy behaviors which can help show the superiority of parenting behaviors over outside influences.

Quantitative, Qualitative (How do you know?)

Quantitative because it is a randomized trial and discussing the methods and results of an intervention.

Qualitative because it uses pre/post surveys to understand the effects of an intervention.

Qualitative because no experimentation was done and focus groups were held to determine themes.

Purpose Statement

An attachment-based, relational approach may also help address some of the common barriers encountered in childhood obesity prevention programs.

To reduce the racial/ethnic disparities, obesity prevention programs and interventions for Hispanic parents are urgently needed.

To investigate the challenges and facilitators to promoting a healthy environment at home and to identify communication preferences to inform intervention strategies for effectively reaching low-income urban minority families.

Research Question

Can this approach potentially avoid the use of negative and counterproductive parenting practices, while addressing a number of the key barriers to implementing healthy lifestyle recommendations?

Do parents influence their child’s health behaviors through the home environment and their parenting practices?

Do parents shape their children’s health-related practices through their modeling of healthful practices; their knowledge of nutrition, and the meal structure and eating patterns established in the home?

Outcome

There was no significant difference between the groups at 6 and 12 weeks with respect to the proportions of children meeting screen time recommendations (<1 hour/day), meeting sleep guidelines (>11 hours/day), eating at least 2 servings of fruit per day, eating at least 2 servings of vegetables per day, and parents reporting bedtime as being ‘very easy’ or ‘easy’. Further, a significantly greater proportion of children in the intervention group versus control group were classified as only waking rarely during the night (i.e. 1–3 nights per month or less) at both 6 and 12 weeks follow-up (54% vs 22% and 35% vs 64% participants, respectively), and sleeping either ‘well’ or ‘very well’ at 12 weeks (84% vs 50%;

Fifty-two, primarily Hispanic (93%) parents completed the intervention (39% attrition rate). For parents who completed the intervention, there was a significant increase in one of the feeding practice subscales: encouragement of balance and variety (p = 0.01). There were significant improvements in several parent and child diet and activity outcomes (p ≤ 0.01).

Analyses yielded the following major themes in parents’ perceptions about the home-food environment related to parents’ outcome expectations and social environment: (1) the importance of parents modeling desired behaviors; and (2) coping with satisfying children’s dislike of vegetables.

Setting

(Where did the study take place?)

In the family home of participants in Auckland, New Zealand.

Parents living in Olneyville and South Providence, Rhode Island

Four focus groups with parents of elementary-aged children attending public elementary schools in low SES communities of New York City.

Sample

54 participants randomized to the intervention (n = 27) or wait-list control (n = 27) groups

Participants were eligible to participate if they were a parent or primary caregiver of a child between 3 and 11 years of age at the beginning of enrollment and spoke English or Spanish. During the first year, 44 parents enrolled, 50 in year two (N = 94), with a total of nine groups of parents completing the intervention over the 2-year period.

16 parents, 4 in each group

Method

Descriptive

Nonexperimental pre/post survey

Focus group interviews

Key Findings of the Study

All measures improved in the hypothesized direction for the intervention group.

Although attrition rates were high, parents completing the study reported enjoying and being satisfied with the intervention. For parents who completed the intervention, reported ‘encouragement of balance and variety’, in addition to several health behaviors significantly improved.

The most common barriers to parents providing healthy foods to their children were accommodating child preferences and familial opposition. Parents showed intentionality to engage in healthy behaviors, and often shared procedural knowledge for reaching health goals. The analyses of desired communication channels yielded major preferences: tailored information, information provided through multiple mediums, appropriate duration/frequency of messages, and presented from a voice of authority.

Recommendations of the Researcher

A larger study is warranted.

Larger studies utilizing an experimental design, should further explore the impact of the HCHF curriculum on improving certain FPPs and health behaviors that contribute to obesity.

Multi-media supports such as workshops, flyers, and text messaging may be useful to facilitate the sharing of information to minimize the tensions between intentionality and reaching desired goals to be healthy. Some parents thought that information received through text messaging could be easily shared and would act as a voice of authority to support child behavior change.

Criteria

APA-Formatted Article Citation with Permalink

How Does the Article Relate to the PICOT Question?

Quantitative, Qualitative (How do you know?)

Purpose Statement

Research Question

Outcome

Setting

(Where did the study take place?)

Sample

Method

Focus group interviews

Experimentation, randomized controlled trial

Key Findings of the Study

Recommendations of the Researcher

Article 4

Article 5

Article 6

Fuller, A. B., Byrne, R. A., Golley, R. K., & Trost, S. G. (2019). Supporting healthy lifestyle behaviours in families attending community playgroups: parents’ perceptions of facilitators and barriers. BMC Public Health, 19(1), 1–11. https://doi-org.lopes.idm.oclc.org/10.1186/s12889-019-8041-1

Somaraki, M., Eli, K., Sorjonen, K., Ek, A., Sandvik, P., & Nowicka, P. (2020). Changes in parental feeding practices and preschoolers’ food intake following a randomized controlled childhood obesity trial. Appetite, 154. https://doi-org.lopes.idm.oclc.org/10.1016/j.appet.2020.104746

E. Whitney Evans, Rena R. Wing, Denise F. Pierre, Whitney C. Howie, Morgan Brinker, & Elissa Jelalian. (2020). Testing the effect of summer camp on excess summer weight gain in youth from low-income households: a randomized controlled trial. BMC Public Health, 20(1), 1–10. https://doi-org.lopes.idm.oclc.org/10.1186/s12889-020-09806-y

This article investigated problems that parents reported regarding promoting healthy behaviors and looked for ways to support parents. Parents being the focus again shows their superiority in modeling behaviors for their children.

This study specifically shows how changing parenting behaviors can reduce childhood obesity.

This article looks at outside behaviors to determine whether they can combat poor parental behaviors to reduce childhood obesity.

Qualitative because a focus group was held to discover themes.

Qualitative because it is a randomized trial

Quantitative because it is a randomized controlled trial.

The aim of the study was to identify barriers and facilitators to using autonomy supporting parenting practices. A secondary aim was to determine parent preferences in respect to an intervention program to be delivered in community playgroups.

To analyze secondary outcomes of the More and Less study (ML study), a randomized controlled trial (RCT) assessing obesity interventions for preschool-age children.

To determine the feasibility and preliminary effectiveness of summer camp in preventing excess summer weight gain among youth from low-income households.

Is autonomy supporting parenting practices crucial for the development of self-regulation and the internalization of healthy behaviors in children?

Will better insight into how family subsystems affect behaviors that drive changes in child weight status inform more effective and tailored obesity interventions?

In the absence of the routine and structure provided by the school day, can children have greater engagement in obesogenic behaviors?

Qualitative content analysis was used to analyze the focus group data, using NVivo 12. The main categories were the SCT constructs of parental behavioral capability and parental self-efficacy and the SDT construct of autonomy promoting parenting practices. The generic categories were the facilitators and barriers within each main category. When participants discussed parenting practices, knowledge of guidelines or knowledge of supportive parenting practices was coded as a facilitator of behavioral capability. If a comment demonstrated a lack of knowledge, then it was coded to a barrier to behavioral capability. Comments that inferred confidence in parenting, optimism, or receiving support as a parent were coded as facilitators of parental self-efficacy. Comments related to feeling stressed, tired or guilty were coded a barriers. The coding of facilitators and barriers to autonomy promoting parenting practices centered around comments about positive or negative factors in the home environment, family influences, support from peers, parent intentions to use supportive parenting practices, and specific examples of either autonomy-promoting or non-autonomy-promoting parenting practices.

Background characteristics were compared across the three treatment groups at baseline using one-way ANOVA and chi-squared test. On average, children were 5.2 years old and had a BMI SDS of 3.0 at baseline. Their mothers and fathers reported higher restriction (3.8 and 3.5) and monitoring (4.0 and 3.8) compared to pressure to eat (2.1 and 2.3) at baseline, respectively. As compared to mothers, fathers reported lower levels of restriction (3.5 vs. 3.8) and monitoring (3.8 vs. 4.0).

Ninety-four participants were randomized to CAMP (n = 46) or SAU (n = 48), of whom 93.0 and 91.6% completed end of school and end of summer assessments, respectively. While CAMP participants attended only 50% of camp days offered, on average, they lost − 0.03 BMIz units while those in SAU gained 0.07 BMIz units over the summer (b = 0.10; p =.02). Group differences in change in energy intake from the school year to summer were borderline significant, as energy intake remained relatively unchanged in CAMP participants but increased among participants in SAU (p = 0.07).

Parents were recruited through Playgroup Queensland (PGQ), a not-for-profit organization in Brisbane, Australia.

Stockholm County, Sweden

This randomized controlled trial was carried out in two low-income communities in the Northeast paret of the US during summers 2017 and 2018.

Five focus groups with parents (n = 30) were conducted in May 2018. Most of the participants were mothers [1], and the majority (76%) had a child at playgroup aged between 2 and 4 years.

174 children with obesity and their parents

A total of 96 participants enrolled in this study and were randomized to CAMP (n = 48) or to SAU (n = 48).

Experimentation, randomized controlled trial

Barriers included beliefs around the need to use rewards to encourage child eating, beliefs around the need for screens as babysitters, and feeling disempowered to change sleep behaviors. Parents were enthusiastic about a potential program that would leverage off the existing playgroup support networks, but they did not want to be “educated”, or to lose their “playgroup time” to an intervention. Rather they wanted strategies and support to deal with the frustrations of food, screen and sleep parenting.

The researchers conducted this study to understand whether the greater decrease in child weight status in the parent support programs group could be explained by changes in parental feeding practices. However, their hypothesis was not confirmed.

Randomizing children to attend summer day camp or experience an unstructured summer as usual was effective in this low-income sample. The findings support the potential for summer camps in mitigating excess summer weight gain.

Studies exploring the feasibility and potential efficacy of a peer-facilitated childhood obesity prevention intervention, delivered in a community playgroup setting, are warranted.

Because intermediary processes involving parenting practices and parent-child interactions may be important, future studies should examine whether general parenting practices moderate the effect of feeding practices on child weight status.

A larger randomized trial is needed explore efficacy, cost-effectiveness and longer-term effects of attending summer camp on weight and weight-related behaviors.

© 2019. Grand Canyon University. All Rights Reserved.

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CRITICAL APPRAISAL 3

Critical Appraisal

Benadeth Geoffrey

January 31, 2021

Critical Appraisal

In this paper, I will be selecting two articles related to nursing practice. The articles selected are quantitative and they provide the important interventions which are required to solve various issues and job dissatisfaction which is seen to be a major issue in nursing practice. Thus, one of the articles that I chose was by Gausvik, Lautar, Miller, Pallerla, & Schlaudecker (2015). In this article, burnouts have been described as physiological reactions that arise when the characteristic of an individual mixes with the work characteristics.

In this article, the authors are seen to employ the use of the JD-R model. This model is used in testing the effects of burnouts in association to work effectiveness of nurses. The goal of this study was to test the effects of the workloads, emotional, and organizational demands on emotional exhaustion among nurses. Moreover, the research question posed by this article is that, whether job demands have an effect on depersonalization and emotional exhaustion among nurses.

Furthermore, the second article which I chose was done by Montgomery, Spânu, Băban, & Panagopoulou in 2015. The purpose of this study was to examine the patient-and-family-centered use of Structured Interdisciplinary Bedside Rounds (SIBR) when taking care of old patients. The aspect being addressed in this article is the satisfaction of job in association to nurses which has an influence towards the retention and communication improvement that can assist in solving the problem. In the paper, the research question is whether improved communication via teamwork improves job satisfaction.

How the Articles Support Nursing Practice

According to Gausvik et al., (2015), nurses should be able to integrate different ways which is important in improving the communication. This can be done through various ways. For example, formation of interdisciplinary team rounds is seen to improve the communication. It is seen that the team rounds help in improving coordination and teamwork in caregivers. This approach is important in the sense that, it helps in improving satisfaction among nurses.

Moreover, my PICOT question is answered by the article in the sense that, it looks into the impacts of interdisciplinary rounds on job satisfaction. It is seen that nurses usually raise questions during team rounds in regard to the working conditions they are subjected to. This is crucial in improving the hospital’s culture. Bedside nurses are the group that was used during the study. On the flip side, according to Montgomery et al., (2015), it is seen that various job stressors in nursing practice will continue to increase in the coming years. This is attributed to the improved care that is expected in future. In any profession therefore, teamwork is vital practice. Thus, my PICOT question is effectively answered by the article where it examines how job burnouts can be reduced due to the engagement among healthcare workers. The group used in this study is similar in my PICOT statement.

Method of Study

From the analysis of the two articles, I will be comparing the method of study seen in these articles. Looking into the article done by Gausvik et al., (2015), it is evident that there is the use of experimental design in establishing the effect of communication on work satisfaction among nurses. The experimental research design is often known as true experimentation which seeks to establish the cause and effect of one variable in the research study. The approach of the study method seen in Gausvik et al., (2015) is important in that it is straightforward and basic. On the other hand, the study method seen here has some limitations. This is because the researcher should always adhere to the various ethical guidelines present.

Also, in the article done by Montgomery et al., (2015), the study method used is the correlation design. This method tries to explore the relationship between various variables. Thus, the correlation design looks into whether an increase of one variable may result in either a decrease or increase in another variable. The study is important in that it argues that teamwork has a positive impact on engagement. There is a limitation which is depicted in this article in that, the correlation does not directly show the cause.

Results of the Study

The key findings that are depicted in the article done by Gausvik et al., (2015) is that 100% of ACE staffs were seen to be comfortable during the bedside rounds. Also, it was seen that only 96% of the ACE staffs agreed that teamwork helped in reducing burnouts and job dissatisfaction (Gausvik et al., 2015). Moreover, the study shows that, 92% of the nurses agreed that communication played a significant role in helping in improving teamwork in hospitals (Gausvik et al., 2015). During the process of research, it was found that a member of the staff said that she felt she is part of a team while working as a group as opposed to working alone.

The key finding depicted in the article done by Montgomery et al., (2015) was that the work demand is correlated and has a positive correlation to burnouts. The authors also found that a negative correlation to burnouts and work demand was depicted during teamwork but has a positive relationship to engagement.

Ethical Considerations

During research, there are various ethical considerations which a researcher needs to take into account. The two examples of ethical considerations that need to be considered are informed consent and respect for anonymity and confidentiality. Thus, from the selected articles above, the researchers are seen to use these ethical considerations in various ways. For example, the article done by Gausvik et al., (2015) depicts a respect for anonymity and confidentiality in that, the authors did not reveal the identity of a nurse who said that she felt she is part of a team while working as a group as opposed to working alone. This is important because the authors have respected the opinion of the nurse to not reveal his or her identity for fear of the unknown.

On the other hand, the article done by Montgomery et al., (2015) also uses ethical consideration during research in the sense that, there is an informed consent. This is done where the authors receive consent from the selected groups in determining the role of teamwork and correlation to various aspects.

Conclusion

The nursing practice is very stressful and demanding sometimes. Therefore, nurses are expected to make informed decisions which are important to the health of the patient. Today, various hospitals have increased workloads due to understaffed personnel. From the discussed articles above, it is seen that they have provided a great insight to my PICOT questions.

References

Gausvik, C., Lautar, A., Miller, L., Pallerla, H., & Schlaudecker, J. (2015). Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, understanding of care plan and teamwork as well as job satisfaction. Journal of Multidisciplinary Healthcare, 33. doi:10.2147/jmdh.s72623

Montgomery, A., Spânu, F., Băban, A., & Panagopoulou, E. (2015). Job demands, burnout, and engagement among nurses: A multi-level analysis of ORCAB data investigating the moderating effect of teamwork. Burnout Research, 2(2-3), 71-79. doi:10.1016/j.burn.2015.06.001

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