Assignment Item 3 king essay”

Total word 2700
Please complete the following the activities by filling in the spaces below. This is a word document so you can add space as needed.
The chosen scenarios for Assessment Item 1 was as follows-
Scenario 1: Depression
You are a community mental health nurse in Sydney. In a recent review of referrals to your service it was noted that there has been a large number of clients referred for treatment of depression. The treatment provided by your service for these clients is antidepressant medication. Some of your patients, however, are not keen to take antidepressant medications for different reasons. You are aware that in other mental health services psychological interventions such as cognitive behavioural therapy (CBT) are offered as an alternative or adjunct to medication. Your team is open to change and it is decided to search for evidence of the most optimal care for these clients.
PART 1: DEVELOPING A FOCUSED QUESTION AND ACQUIRING RELEVANT EVIDENCE

1. My PICO breakdown look like for the above scenario is as follows-

Population/Patient: Patient with depression
Intervention: Psychological intervention such as cognitive behavioural therapy
Comparison: Antidepressant drugs
Outcome: Reduce depression symptoms.

2. PICO research question

In the patient with depression (P), is psychological intervention such as cognitive behavioural therapy (I) as effective treatment as the antidepressant drug(C) to reduce depression symptoms (O)?

3. What type of clinical question do you think this PICO answers?
It is believed that, this answer is therapeutic.

4. 4. The keywords and medical subject headings for our example scenario would look like this

Population
Intervention
Comparison
(not commonly used in actual database search strategy) Outcome
(not commonly used in actual database search strategy)
Main search term:

Depression,
Mood disorder, Mental disorder,
Depressive disorder,
Depress* Main search term:
Cognitive behavioural therapy,
Psychological -intervention, Psychological treatment for depression,
Behavioural* therapy,
Psycho*therapy,
Main search term:
Antidepressive Agents,
Depress* medication,
Depress* drug,

Main search term:
Reduce -depression -symptoms,
Cure depression,

Remedy of depression,

Depression treatment

5. The inclusion criteria for refine search results are as follows-
Gender: Both. Age Range: All
Publication Dates: 20011 to 2016, Language: English.

6. What kind of study do you think would best answer your question? Select here which type of article you might want to access. You can also use these to refine your search if you have a lot of papers.
According to my point of view, psychological intervention for treating depression would be the best answer for this case. I want to access randomized controlled trial (RCT) type’s article.

7. Systematic Search Plan / Search Strategy

Key terms:
1 Depression
2 Mood disorder
3 Mental disorder
4 Depress*
5 Antidepressive Agents
6 Depress* medication
7 depress* drug
8 Cognitive behavioural therapy
9 Psychological -intervention
10 Psychological treatment for depression
11 Behavioural* therapy
12 Psycho*therapy
13 Depression OR Mood disorder OR Mental disorder OR Depress*
14 Antidepressive Agents OR Depress* medication OR depress* drug

15 Cognitive behavioural therapy OR Psychological -intervention OR Behavioural* therapy OR Psycho*therapy
16 13 (Depression OR Mood disorder OR Mental disorder) AND 14(Antidepressive Agents OR Depress* medication OR depress* drug) AND 15(Cognitive behavioural therapy OR Psychological -intervention OR Behavioural* therapy OR Psycho*therapy)

PART 2: EVIDENCE OF APPLICATION OF SEARCH STRATEGY (PLAN) IN DATABASE SEARCHES
Enter your search into two different databases of your choice (such as Medline and CINHAL) using the your Systematic Search Plan and the skills you have learnt.

8. Place the screenshots/screengrabs/digital pictures of your two (2) databases here. Please ensure your screenshots provide all steps of your search and are clear enough to be legible – these must be READABLE!!

Database search 1

Add space as needed

Database search 2

Add space as needed

9. Place the abstract of your selected randomised controlled trial here. Please add this as a screenshot, do not retype this yourself. (The abstract must be readable)

Add space as needed

10. Place the abstract of your selected qualitative study here. Please add this as a screenshot, do not retype this yourself. (The abstracts must be readable).

Add space as needed
 
PART 3.1 APPRAISAL OF YOUR RANDOMISED CONTROLLED TRIAL (Please consider the word limit for each question, 13 marks )
Assessing the quality of the available evidence has also been a key focus this semester. Use the CASP tool for RCTs below to appraise the quality of your selected RCT.

Section A: Are the results of the trial valid?

Screening Questions

1. Did the trial address a clearly focused issue?
Yes No Can’t tell
Justify your answer: (Max 50 words)

HINT: An issue can be ‘focused’ In terms of
• The population studied
• The intervention given
• The comparator given
• The outcomes considered
2. Was the assignment of patients to treatments randomised? (Max 100 Words)
Yes No Can’t tell
Justify your answer:

HINT: Consider
• How was this carried out?
• Was the allocation sequence concealed from
3. Were all of the patients who entered the trial properly accounted for at its conclusion? (Max 100 words)
Yes No Can’t tell
Justify your answer:

HINT: Consider
• Was the trial stopped early?
• Were patients analysed in the groups to which they were randomised?

Detailed questions

4. Were patients, health workers and study personnel ‘blind’ to treatment? (Max 100 words)
Yes No Can’t tell
Justify your answer:

HINT: Think about
• Patients?
• Health workers?
• Study personnel?

5. Were the groups similar at the start of the trial? (Max 100 words)
Yes No Can’t tell
Justify your answer:

HINT: Look at
• Other factors that might affect the outcome such as age,
• sex, social class
• researchers and patients?

6. Aside from the experimental intervention were the groups treated equally? (Max 100 words)
Yes No Can’t tell
Justify your answer:

Section B: What are the results?
7. How large was the treatment effect? (Max 150 words)
Justify your answer:

HINT: Consider
• What outcomes were measured?
• Is the primary outcome clearly specified?
• What results were found for each outcome?

8. How precise was the estimate of the treatment effect? (Max 100 words)
Justify your answer:

HINT: Consider
• What are the confidence limits?

Section C: Will the results help locally?

9. Can the results be applied in your context? (or to the local population?) (Max 100 words)
Yes No Can’t tell
Justify your answer:

HINT: Consider whether
• Do you think that the patients covered by the trial
• are similar enough to the patients to whom you will
• apply this?, if not how to they differ?

10. Were all clinically important outcomes considered? (Max 50 words)
Yes No Can’t tell
Justify your answer:

HINT: Consider
• Is there other information you would like to have seen?
• If not, does this affect the decision?

11. Are the benefits worth the harms and costs? Yes Can’t tell No (Max 100 words)
Justify your answer:

HINT: Consider: Even if this is not addressed by the review, what do you think?

PART 3.2 APPRAISAL OF YOUR QUALITATIVE ARTICLE (please consider the word limit for each question, 11marks )

Use the CASP Appraisal for Qualitative Research below to decide whether the information presented in your paper is trustworthy and truly reflective of the participant’s voice.

SCREENING QUESTIONS

1. Was there a clear statement of the aims? ☐Yes ☐ Can’t tell ☐ No
HINT: Consider
• What was the goal of the research?
• Why it was thought important?
• Its relevance

Your comment: (max 100 words)

2. Is a qualitative methodology appropriate? ☐Yes ☐ Can’t tell ☐ No
HINT: Consider
• If the research seeks to interpret or illuminate the actions and/or subjective experiences of research participants
• Is qualitative research the right methodology for addressing the research goal?

Your comment: (max 50 words)

DETAILED QUESTIONS
3. Was the research design appropriate to address the aims of the research? ☐Yes ☐ Can’t tell ☐ No
HINT: Consider
• If the researcher has justified the research design (e.g. have they discussed how they decided which method to use)?

Your comment: (max 50 words)

4. Was the recruitment strategy appropriate to the aims of the research? ☐Yes ☐ Can’t tell ☐ No
HINT: Consider
• If the researcher has explained how the participants were selected
• If they explained why the participants, they selected were the most appropriate to provide access to the type of knowledge sought by the study
• If there are any discussions around recruitment (e.g. why some people chose not to take part)

Your comment: (max 100 words)

5. Was the data collected in a way that addressed the research issue? ☐Yes ☐ Can’t tell ☐ No
HINT: Consider
• If the setting for data collection was justified
• If it is clear how data were collected (e.g. focus group, semi-structured interview etc.)
• If the researcher has justified the methods chosen
• If the researcher has made the methods explicit (e.g. for interview method, is there an indication of how interviews were conducted, or did they use a topic guide)?
• If methods were modified during the study. If so, has the researcher explained how and why?
• If the form of data is clear (e.g. tape recordings, video material, notes etc.)
• If the researcher has discussed saturation of data

Your comment: (Max 150 words)

6. Has the relationship between researcher and participants been adequately considered ☐Yes ☐ Can’t tell ☐ No
HINT: Consider
• If the researcher critically examined their own role, potential bias and influence during
a) Formulation of the research questions
b) Data collection, including sample recruitment and choice of location
• How the researcher responded to events during the study and whether they considered the implications of any changes in the research design

Your comment: (max 50 words)

7. Have ethical issues been taken into consideration? ☐Yes ☐ Can’t tell ☐ No
HINT: Consider
• If there are sufficient details of how the research was explained to participants for the reader to assess whether ethical standards were maintained
• If the researcher has discussed issues raised by the study (e.g. issues around informed consent or confidentiality or how they have handled the effects of the study on the participants during and after the study)
• If approval has been sought from the ethics committee

Your comment: (Max 50 words)

8. Was the data analysis sufficiently rigorous? ☐Yes ☐ Can’t tell ☐ No
HINT: Consider
• If there is an in-depth description of the analysis process
• If thematic analysis is used. If so, is it clear how the categories/themes were derived from the data?
• Whether the researcher explains how the data presented were selected from the original sample to demonstrate the analysis process
• If sufficient data are presented to support the findings
• To what extent contradictory data are taken into account
• Whether the researcher critically examined their own role, potential bias and influence during analysis and selection of data for presentation

Your comment: (max 100 words)

9. Is there a clear statement of findings? ☐Yes ☐ Can’t tell ☐ No
HINT: Consider whether
• If the findings are explicit
• If there is adequate discussion of the evidence both for and against the researchers arguments
• If the researcher has discussed the credibility of their findings (e.g. triangulation, respondent validation, more than one analyst)
• If the findings are discussed in relation to the original research question

Your comment: (max 100 words)

10. How valuable is the research? (max 100 words)
HINT: Consider
• If the researcher discusses the contribution the study makes to existing knowledge or understanding e.g. do they consider the findings in relation to current practice or policy? or relevant research-based literature?
• If they identify new areas where research is necessary
• If the researchers have discussed whether or how the findings can be transferred to other populations or considered other ways, the research may be used

Your comment:

PART 4.1 OVERALL SUMMARY (400 words, 11 marks)
11. Provide an overall summary of what these two papers contribute to answering your research question
HINT: Consider
• What was your original clinical question?
• What information do you think is useful from these two articles?
• Do you think the information in the articles is unbiased?
• If the information from the articles helpful in answering your overall question?

PART 4.2 SYNTHESISING THE EVIDENCE (300 words, 5 marks)
Finally, you need to summarise the evidence that relates to your clinical questions in simple language as if you were explaining the rationale for your clinical decision making to a patient within your care.