Critical Appraisal of Research Comprehensive Nursing Paper Example
Use this document to complete the evaluation table requirement of the Module 4 Assessment, Evidence-Based Project, Part 4A: Critical Appraisal of Research
| Full APA formatted citation of selected article. | Article #1 | Article #2 | Article #3 | Article #4 |
| Van Hooser, J. C., Rouse, K. L., Meyer, M. L., Siegler, A. M., Fruehauf, B. M., Ballance, E. H., … & Lutfiyya, M. N. (2020). Knowledge of heart attack and stroke symptoms among US native American adults: a cross-sectional population-based study analyzing a multi-year BRFSS database. BMC public health, 20(1), 1-10.(Critical Appraisal of Research Comprehensive Nursing Paper Example) | Breathett, K., Sims, M., Gross, M., Jackson, E. A., Jones, E. J., Navas-Acien, A., … & American Heart Association Council on Epidemiology and Prevention; Council on Quality of Care and Outcomes Research; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; and Council on Lifestyle and Cardiometabolic Health. (2020). Cardiovascular health in American Indians and Alaska Natives: a scientific statement from the American Heart Association. Circulation, 141(25), e948-e959 | Harris, R., Nelson, L. A., Muller, C., & Buchwald, D. (2015). Stroke in American Indians and Alaska Natives: a systematic review. American Journal of Public Health, 105(8), e16-e26. | Boden-Albala, B., Allen, J., Roberts, E. T., Bulkow, L., & Trimble, B. (2017). Ascertainment of Alaska native stroke incidence, 2005-2009: lessons for assessing the global burden of stroke. Journal of Stroke and Cerebrovascular Diseases, 26(9), 2019-2026.(Critical Appraisal of Research Comprehensive Nursing Paper Example) | |
| Evidence Level * (I, II, or III) | II | I | III | II |
| Conceptual Framework Describe the theoretical basis for the study (If there is not one mentioned in the article, say that here).** | The study aimed to investigate the knowledge levels of stroke and heart attack among Native American Patients to develop health interventions to alleviate possible knowledge disparities. | None | None | The study aimed to describe the health care systems serving the culturally diverse rural and urban communities and report on stroke incidence among Alaska Natives. |
| Design/Method Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria). | A module from the Behavioral Risk Factor Surveillance System (BRFSS) was studied using the complex multivariate and bivariate techniques. BRFSS is a health telephone survey overseen by centers for Disease control and prevention. The inclusion criteria applied in the study entailed using subjects 18years old and above while individuals below 18 years were excluded. Again, if a state used the heart attack and stroke symptomology module in multiple years, only the data from the most recent year were used. | MEDLINE, Centres for Disease Prevention and control and the the annual Heart Disease and Stroke Statistics report from the American Heart Association were used to identify the risk factors and interventions for American Indians and Alaska Natives.(Critical Appraisal of Research Comprehensive Nursing Paper Example) | The study conducted a systematic review of published work on prevalence of stroke among American Indians and Alaska Natives. The inclusion criteria was high stroke prevalence among American Indians and Alaska Natives than other racial and ethnic groups in the US. The exclusion criteria used was when a sample was a non- Us, and when the disease involved was not a stroke case. | The Alaska Native Stroke Registry (ANSR) screened and captured the stroke cases recorded in the study. Also, medical records were used to review the incidences of stroke among Alaska Natives(Critical Appraisal of Research Comprehensive Nursing Paper Example) |
| Sample/Setting The number and characteristics of patients, attrition rate, etc. | Native American adults, around 6.2 million people of US population were used as study sample to determine knowledge levels in stroke and heart attack patients. Notably, the native Americans 2.3 odds high of developing diabetes than non-Hispanic Caucasians, a condition that highly predisposes then to stroke and heart attack. Setting was both rural and urban areas . | Approximately 5.2 million American Indians and Alaska Natives were used as study subjects. Diabetes Mellitus is a major characteristic that leads to high rates of cardiovascular disease in American Indians and Alaska Natives compared to other racial and ethnic groups | The study was a systematic review of 57 referred publications on stroke epidemiology among Alaska Natives and American Indians. Stroke is highly prevalent among the mentioned groups with the risks evident in young ages that non- Hispanic whites posing a high mortality rate in American Indians and Alaska Natives | The study population was Alaska Natives living in rural and urban areas. In a period of 4 years the study investigated over 2100 alerts and identified 514 unique stroke cases |
| Major Variables Studied List and define dependent and independent variables | Independent variable- Age Dependent Variables Low heart attack knowledge score Low stroke knowledge score In this case, an independent variable cannot be change for instance patient’s ages while a while dependent variable can be changed by the researcher.(Critical Appraisal of Research Comprehensive Nursing Paper Example) | Independent Variable- Age and Race Dependent variable- Body weight, High density lipids | Independent Variables– race American Indians and Alaska Natives, Stroke prevalence Dependent factors-Post Stroke outcomes(Critical Appraisal of Research Comprehensive Nursing Paper Example) | Independent variable- Stroke incidences |
| Measurement Identify primary statistics used to answer clinical questions (You need to list the actual tests done). | The BRFSS heart and stroke symptomology module consisted of 13 questions which assess a person’s knowledge of early symptoms of heart attack and stroke. BRFSS participants were asked if the following were symptoms of a heart attack: pain or discomfort in the jaw, neck, or back; feeling weak, lightheaded, or faint; chest pain or discomfort; pain or discomfort in the arms or shoulders; shortness of breath. BFSS participants were asked if the following were symptoms of stroke: sudden confusion; trouble speaking or understanding; sudden numbness or weakness of face, arm, or leg; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, or loss of balance or coordination; or sudden, severe headache with no known cause.(Critical Appraisal of Research Comprehensive Nursing Paper Example) | Primary measurements were Blood pressure, cholesterol levels, body weight and the albumin levels Other modifiable risk factors were smoking and level of physical activity | Blood pressure, body weight examination and use of tobacco and alcohol tests revealed high incidences of stroke | Patients were screened to determine the type of strokes Again, patients’ medical records were used to gain critical information about the health conditon(Critical Appraisal of Research Comprehensive Nursing Paper Example) |
| Data Analysis Statistical or Qualitative findings (You need to enter the actual numbers determined by the statistical tests or qualitative data). | The study revealed that Native American Adults with low stroke and heart attack composite knowledge score were likely to be poor, less educated, rural resident, uninsured, male, without a primary care provider and lacking frequent medical check-up. | Diabetes Mellitus is a major risk factor for CVD for American Indians and Alaska Natives. Other risk factors include high low LDLs, hypertension, physical inactivity and smoking(Critical Appraisal of Research Comprehensive Nursing Paper Example) | The review charts revealed that tests on hypertension, obesity and smoking pose a risk of cerebrovascular disease with American Native being a high risk group | Over the 4 years, the screened case revealed 514 unique strokes and 372 incidents. Of the 372 incidences, 2932 were ischemic strokes, 47 intracranial hemorrhagic strokes, 30 subarachnoid hemorrhagic strokes and 3 were unknown.(Critical Appraisal of Research Comprehensive Nursing Paper Example) |
| Findings and Recommendations General findings and recommendations of the research | Social status and level of education highly impacted ones’ knowledge on stroke and heart attack. | American Indians and Alaska native are prone to CVD due to Diabetes Mellitus. Modifiable risk factors should alleviated to reduce the morbidity and mortality rates. | Stroke is highly prevalent among American Indians and Alaska Natives than other native racial and ethnic populations. | The incidences on Alaska natives are higher as compared to other white US citizen Alaska Natives should be educated on the risk factors |
| Appraisal and Study Quality Describe the general worth of this research to practice. What are the strengths and limitations of study? What are the risks associated with implementation of the suggested practices or processes detailed in the research? What is the feasibility of use in your practice? | The research is essential in eliminating health knowledge disparities that increase mortality rates. Limitations- the study did not conduct actual experiments therefore valid evidence could have been missed. Strengths- large study sample was used thus likelihood of accuracy. There are risks of missing critical information since no practical observations are made The benefits outweigh the risks thus the study cost friendly(Critical Appraisal of Research Comprehensive Nursing Paper Example) | The benefits outweigh the risks thus the study cost friendly and educative for preserving life(Critical Appraisal of Research Comprehensive Nursing Paper Example) | The review is essential in the management of stroke patients and reducing negative outcomes such as disability. Strengths– the study used inclusion and exclusion criteria to generate reliable publications for the riview Limitation-PubMed search algorithm used was not specific and sensitive and missed many titles relating to stroke epidemiology(Critical Appraisal of Research Comprehensive Nursing Paper Example) | The study is essential in identifying Alaska Natives as a high risk group, educate and intervene in reducing post stroke outcomes. Strengths- The study utilized accurate result and medical records to determine patient health status. |
| Key findings | Education and social economic status influence one’s health seeking behavior | CVD incidences can be reduced if the risk factors are addressed. | Stroke has high prevalence among American Indians and Alaska Natives that other racial and ethnic groups in the US | Stroke has high prevalence among Alaska Natives that other racial and ethnic groups in the US |
| Outcomes | The article offers level one evidence offering best outcomes in amending professional practice | The article offers level one evidence offering best outcomes in amending professional practice | The article is relevant in interventions that aim to reduce post stroke outcomes | The article is relevant in interventions that aim to reduce post stroke outcomes |
| General Notes/Comments | The study is relevant to study s larger population | The study is relevant to studys larger population (Critical Appraisal of Research Comprehensive Nursing Paper Example) | The study enhanced ones knowledge, provided evidence, and reliable publications on stroke information | The study improved ones knowledge, provided evidence, and reliable information on stroke(Critical Appraisal of Research Comprehensive Nursing Paper Example) |
Critical appraisal: Evidence-based practice
The best practice emerging from the research article is medical personnel education dissemination, i.e., clinical pharmacists, to educate patients on stroke and heart attack symptoms. The reviewed articles portray knowledge deficits on stroke symptomology as a crucial factor contributing to susceptibility among Native Americans (Boden-Albala et al., 2017; Van Hooser et al., 2020; Breatherr et al., 2020; Harris et al., 2015). Van Hooser et al. (2020) and Breathett et al. (2020) argue that educational attainment is the most significant risk factor predisposing Native Americans to cardiovascular illnesses, including stroke. Van Hooser et al. (2020) argue that Educational programs and initiatives aimed at patients with inadequate knowledge on stroke and heart attack symptoms with aid in mitigating lack of knowledge. Similarly, Breathett et al. (2020) argue that focusing on community-based education interventions among affected individuals can help address the risk factor. (Critical Appraisal of Research Comprehensive Nursing Paper Example)
Van Hooser et al. (2020) recommend community-based education intervention through clinical pharmacists to mitigate knowledge deficits. Van Hooser et al.’s (2020) recommendation justifies my proposal to adopt a culture-sensitive educational program to increase stroke awareness and knowledge among Native Americans. In Van Hooser et al.’s (2020) study, composite knowledge on heat attack and stroke and their symptomology was studied. The study found out that a significant number of individuals among the Native American communities having low knowledge on heat attack and stroke was characterized by old age, poverty, less education attainment, no health insurance, no personal HCP, unable to meet medical care costs, and improper routine medical checkup. In this regard, a culture-sensitive education program can increase their knowledge of stroke and associated symptomologies.(Critical Appraisal of Research Comprehensive Nursing Paper Example)
Breathett et al. (2020) recommend that special risk education programs having tribal and organizational support and disseminated by health educators and clinicians are vital in creating public awareness and monitoring stroke progress in Native American Communities. Education initiative components such as blood pressure control and medication adherence are significant components of a stroke education program. Clinical pharmacists and other healthcare personnel play crucial roles in educating patients about stroke because of several reasons. One, pharmacists are easily accessible and knowledgeable health care practitioners. Second, pharmacists are traditionally responsible for educating and providing interventions for patients under specific public health initiatives. For instance, research has shown that physician–ph pharmacist collaboration can help reduce risks associated with blood pressure, which is a primary factor for stroke (Anderegg et al., 2016). Therefore, a culture-sensitive education program can significantly mitigate inadequate knowledge and awareness on stroke.(Critical Appraisal of Research Comprehensive Nursing Paper Example)
Furthermore, pharmacists contribute to appropriate education in dispensing settings (Van Hooser et al., 2020). Equally, they provide information on cardiovascular and stroke symptoms to approximately 90% of the US population living in the proximity of community pharmacies. In this regard, pharmacists are considered the most accessible healthcare practitioners, given that they attend to their patients up to 10 times more frequently than other healthcare personnel. Pharmacists and other healthcare personnel can also educate Native Americans on heart attack and stroke during direct patient care sessions. In addition, the coordination between healthcare personnel forms a platform for essential education and medication, leading to better health outcomes and subsequent reduction lack of awareness as a primary risk factor for stroke. (Critical Appraisal of Research Comprehensive Nursing Paper Example)
The practice of stroke education at various levels of intermediary and structural social health determinants should embody trust, focus on risk factors, community empowerment, inspiring ethnic and racial culture and history, and healthcare accessibility (Breathett et al., 2020). Consequently, implementing a culture-sensitive education program can increase access and use of healthcare services, implement relevant stroke mitigation guidelines, reduce social health determinants, and reduce and eventually eliminate health knowledge inequities faced by Native Americans. (Critical Appraisal of Research Comprehensive Nursing Paper Example)
References
Anderegg, M. D., Gums, T. H., Uribe, L., Coffey, C. S., James, P. A., & Carter, B. L. (2016). Physician – pharmacist collaborative management: narrowing the socioeconomic blood pressure gap. Hypertension, 68(5), 1314-1320. (Critical Appraisal of Research Comprehensive Nursing Paper Example)https://doi.org/10.1161/HYPERTENSIONAHA.116.08043
Boden-Albala, B., Allen, J., Roberts, E. T., Bulkow, L., & Trimble, B. (2017). Ascertainment of Alaska native stroke incidence, 2005-2009: lessons for assessing the global burden of stroke. (Critical Appraisal of Research Comprehensive Nursing Paper Example)Journal of Stroke and Cerebrovascular Diseases, 26(9), 2019-2026. https://doi.org/10.1016/j.jstrokecerebrovasdis.2017.06.007
Breathett, K., Sims, M., Gross, M., Jackson, E. A., Jones, E. J., Navas-Acien, A., … & American Heart Association Council on Epidemiology and Prevention; Council on Quality of Care and Outcomes Research; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; and Council on Lifestyle and Cardiometabolic Health. (2020). Cardiovascular health in American Indians and Alaska Natives: a scientific statement from the American Heart Association.(Critical Appraisal of Research Comprehensive Nursing Paper Example) Circulation, 141(25), e948-e959. 10.1161/CIR.0000000000000773
Harris, R., Nelson, L. A., Muller, C., & Buchwald, D. (2015). Stroke in American Indians and Alaska Natives: a systematic review. American Journal of Public Health, 105(8), e16-e26(Critical Appraisal of Research Comprehensive Nursing Paper Example). https://doi.org/10.2105/AJPH.2015.302698
Van Hooser, J. C., Rouse, K. L., Meyer, M. L., Siegler, A. M., Fruehauf, B. M., Ballance, E. H., … & Lutfiyya, M. N. (2020). Knowledge of heart attack and stroke symptoms among US native American adults: a cross-sectional population-based study analyzing a multi-year BRFSS database. BMC public health, 20(1), 1-10.(Critical Appraisal of Research Comprehensive Nursing Paper Example)URL https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-8150-x
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