NRS 433V Introduction To Nursing Research

In the modern medical world, research has become a critical aspect that nurses are encouraged to undertake. Nurses’ responsibilities have diversified from patient advocacy, infection control, physical, management of diseases or signs and symptoms into research exploration to improve the effectiveness of finding solutions and implementing them to improve healthcare (Pooler, 2014). This paper is a critique of the quantitative research of the PICOT Statement and Literature Search and the ethical considerations of the investigation.

The study aimed to understand how depression can be managed using the cognitive research therapy and the internet-based therapy. Further the study aimed at investigating the treatment outcomes of both interventions, and which was more efficient. It then compares these outcomes by using a randomized non-inferiority trial (Wagner, Horn, & Maercker, 2014). The clinical problem identified is the depression in older adults. This clinical problem contributed to the research problem of the difference in performance of using internet-based therapy and the use of face-to-face treatment along with the cognitive behavior therapy to treat depression.

The quantitative analysis comprises a range of methods such as polls, surveys, and questionnaires, concerned with the systematic investigation of social phenomena, using numerical data. A total of 62 participants, diagnosed with depression, took part in the study where 32 participants were randomly allocated to an Internet-based treatment with a psychologist and 30 of them were assigned to a face-to-face treatment intervention over a similar period (8 weeks). Consecutive data was collected after the eight weeks to keep track of the effectiveness of both interventions. The participants seem to have willingly taken part in the study but not the mode of treatment (either online or face- to- face). The author rationalizes this method of collection of data to be most appropriate as it is non- biased and hence the results are likely to be more accurate.  In the paper, the researcher cited relevant current quantitative and qualitative material related to the critical focus of the study.

Moreover, the study uses both the dependent and independent variable to come up with questions that help to carry out the research. The dependent variable is, depression of older adults while the independent variable consists of Internet therapy, face-to-face treatment, and the cognitive-based therapy. Some of the questions that may have been used to conduct the research include; can patients with depression get treatment via Internet platforms or do they only require face-to-face treatment? How effective is the cognitive behavior therapy? And, What are the possible treatments of chronic pain? (Wagner, Horn, & Maercker, 2014). This critique paper agrees that the questions were relevant to the study.

The main clinical problem in the study is the effect of the cognitive behavior therapy, which resulted in the research problem of the impact of cognitive behavior therapy on the control groups (Berking, Ebert, Cuijpers & Hofmann, 2013). The research opens up a discussion on mindfulness-based stress reduction and mindfulness stress cognitive therapy. Other studies on the same topic have helped to explain the positive and negative effects on the reduction of depression. Some other questions used in the development of the research include: What alternative methods can be used instead of cognitive behavior therapy? Which studies support the cognitive behavior therapy? What are some of the effects of cognitive behavior therapy?

The study also compiles its results using the inferential statistics that is as a result of the descriptive statistics. The findings of the study from the internet-based treatment and cognitive therapy are d=1.27 and d=1.37 respectively.  Moreover, the findings suggest that Internet therapy is more effective in the long run which therefore shows that internet therapy can be more useful for patients that are unable to make physical appointments to seek treatment.

The use of web-based treatment with a therapist shows similar outcomes with conventional face-to-face therapies while treating depressive disorders (Ehde, Dillworth, 2014, p.153). It, therefore, means that the research will have a high impact on how nurse will apply the procedures of treatment to patients with depressive disorder since the study gives a synopsis of the different methods that should be in use. According to the research, nurses are advised to incorporate technology into their work because of the changing trends in the world that are altering the delivery of services. The study uses the random controlled trial whose aim is to make a non-biased comparison between modern online-based treatment and traditional face-to-face treatment.

Though the study is successful, it has some weaknesses that raise ethical issues. Firstly, the report utilizes the method of the random controlled trial (RCT) to collect data. Solomon, Cavanaugh, & Draine (2009) criticize the RCT to have some underlying ethical issues. They argue that since RCT is mostly experimental, a moral question arises where there is a possibility of some patients getting better treatment either intervention. Additionally, Flanagin  (2009), Claims that RCT does not allow a patient to choose their preferred mode of treatment and this is a violation of the rule of informed consent. The patients, therefore, lack knowledge of the risks and benefits associated with the chosen mode of treatment. 

The research is also ethical in that it recognizes different researchers and participants. It engages researchers during the discussion and personal information concerning different Individuals are not exposed. This, therefore, shows that the researcher is mindful of patients right to privacy. Additionally, the researcher argues that though the cognitive behavior therapy is useful in solving depression, it does not fulfill its goals well in the long run, but when mindfulness-based stress reduction and mindfulness-cognitive treatment is introduced it increases the efficacy of the procedure. The mindfulness-based intervention is not ethical in a way; this is because information on the different methods used is not given to patients before being incorporated, which makes the research unethical (Gu, Strauss, Bond, and  Cavanagh, 2015).

The presentation of the research was excellent and has a high impact on nursing since it gives a broad overview of how to treat depression. The study also has a significant limitation, where the research quality is heavily dependent on the individual skills of the researcher and more easily influenced by the researcher’s personal biases. Nonetheless, the findings of the research show that depression is likely to reduce when cognitive therapy is applied since it critically analyses the behavior of each patient in a more profound way. In conclusion, it is advisable for a researcher to use the qualitative analysis, because it helps a researcher see the bigger picture and understand the problem directly from a participant because it does assume its findings like the quantitative research, (Morgan, 2008).

References

Berking, M., Ebert, D., Cuijpers, P., & Hofmann, S. G. (2013). Emotion regulation skills training enhances the efficacy of inpatient cognitive behavioral therapy for major depressive disorder: a randomized controlled trial. Psychotherapy and Psychosomatics, 82(4), 234- 245.

Ehde, D. M., Dillworth, T. M., & Turner, J. A. (2014). Cognitive-behavioral therapy for individuals with chronic pain: Efficacy, innovations, and directions for research. American Psychologist, 69(2), 153-166. doi:10.1037/a0035747

Flanagin, A. (2009). Ethical Review of Studies and Informed Consent. AMA Manual of Style. doi:10.1093/jama/9780195176339.022.210

Gu, J., Strauss, C., Bond, R., & Cavanagh, K. (2016). Corrigendum to “How do Mindfulness-Based Cognitive Therapy and Mindfulness-Based Stress Reduction Improve Mental Health and Wellbeing? A Systematic Review and Meta-Analysis of Mediation Studies” [Clinical Psychology Review 37 (2015) 1–12]. Clinical Psychology Review, 49, 119. doi:10.1016/j.cpr.2016.09.011

Morgan, D. L. (2008). Practical Strategies for Combining Qualitative and Quantitative Methods: Applications to Health Research. Qualitative Health Research, 8(3), 362-376. doi:10.1177/104973239800800307

Pooler, A. (2014). An introduction to evidence-based practice in nursing & healthcare. New York, USA: Routledge.

Solomon, P., Cavanaugh, M. M., & Draine, J. (2009). Ethical Considerations of Randomized Controlled Trials. Randomized Controlled Trials, 19-44. doi:10.1093/acprof:oso/9780195333190.003.0002

Wagner, B., Horn, A. B., & Maercker, A. (2014). Internet-based versus face-to-face cognitive-behavioral intervention for depression: A randomized controlled non-inferiority trial. Journal of Affective Disorders, 152-154, 113-121. doi:10.1016/j.jad.2013.06.032