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- QUESTION
DNP-820
Week 4 DQ1 due 11/8/18
Reliability and validity are often misunderstood and not given much notice in research articles. Using any example, demonstrate how you would correctly describe these two terms to a nurse prepared at a bachelor's degree level or below. Then describe why the reliability and validity of a study is important for translation.
Week 4 DQ 2 due 11/10/18
What are the criteria for selecting qualitative versus quantitative resources in relation to your literature review? Which method(s) of research are you selecting? Why?
Week 4 Paper due 11/13/18
Details:
Empirical research is the foundation of scholarly research and scholarly writing. An empirical article is defined as one that reports actual results of a research study. An empirical article includes a description of the study, an introduction, a research question, an explanation of the study's methodology, a presentation of the results of the study, and a conclusion that discusses the results and suggests topics for further study.As you search the library for scholarly research, you should limit your search to identify empirical articles. (You can use the "Empirical Research Checklist" from DNP-801 to assist in this determination.) After finding an empirical study, begin to assess the validity of the conclusion by determining if the conclusion answers the proposed research question and if the methodology is appropriate.
As you move forward in your doctoral journey, you will read research papers that will require you to assess the validity of the studies in question. To accomplish this, qualitative assessments about the research must be made by comparing, contrasting, and synthesizing what the research says.
In this assignment, you will continue to develop the skill of writing, by reviewing 15 research articles associated with your chosen topic and using the content to identify at least five major concepts and subthemes related to your topic.
General Requirements:
Use the following information to ensure successful completion of this assignment:
- Use the "Empirical Research Checklist" to assist in the determination of empirical articles.
- Use the "Research Article Chart" to provide a summary review of each component of your assignment.
- Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
- This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Directions:
Part 1: Selection of 15 Articles
Select 15 empirical articles related to your PICOT question. Use the "Empirical Research Checklist" worksheet to ensure that each article you select meets all of the established criteria. At least one article must demonstrate a quantitative methodology.
Part 2: Research Article Chart
Using the articles acquired in Part 1, provide a summary review of each component using the "Research Article Chart" template.
Part 3: Synthesis of Research Studies
Based upon your review of the 15 research articles, identify at least five major concepts that relate to your project topic, and three subthemes related to each concept.
Using the information from the completed "Research Article Chart," and the major concepts and subthemes you have identified, write a 2,000-3,000 word paper that synthesizes the content of the 15 research studies.
Summarize each major concept and focus on providing a detailed synthesis of the three identified subthemes that support that concept by addressing the following.
- Introduction of the identified subtheme
- Summary of the research questions posed by the studies
- Summary of the sample populations used
- Summary of the limitations of the studies
- Summary of the conclusion and recommendations for further research
| Subject | Nursing | Pages | 13 | Style | APA |
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Answer
PICOT: Mental Illness
Introduction of the identified subtheme
Based on the PICOT question, the three major subthemes that will be addressed in this paper include; role of peer support in mental health care, impact of stigmatization and prejudice in mentally ill patients as well as causes of non-compliance, re-hospitalization in mentally ill patients.
Role of peer support in mental health
Recent trends of mental health care have proven that peer support has a number of benefits which include reduction of psychiatric signs and symptoms, reduced duration of hospitalization, increased patient hope, promotion of patients’ quality of life, reduced readmissions, and promotion of patients’ social support.
Peer support is generally based on the concept that during trying times individuals tend to seek help from their friends and loved ones. Similarly, in mental health care peer specialists accord understanding when patients who have been diagnosed with mental illnesses develop feelings of hopelessness and desperation. Peer support specialists provide patients with a special connection as well as hope which enhances the recovery of mentally ill patients.
A study by Mahlke, et al. (2017) reports that patients who have been enrolled to peer support groups have reduced risk of suffering from stigma. In recent times, most mental care settings have established peer support programs for their patients a good example being the Peer Bridger Program of the New York. One of the objectives of this program was to help mental ill patients to smoothly transition into the society from hospitalization. The program provides patients with emotional support, establishing community goals, facilitation of recovery as well as enhancing their participation in peer support activities. Most patients prefer these set-ups since they are led by individuals who were once mentally ill but have since recovered. The individuals understand what the patients go through, and therefore, are in the best position to advise them and guide them in their journey to complete recovery without relapse.
However, it is of great importance to acknowledge that despite peer support services being essential in promoting mental health care, it is not easy to establish and provide the services. This is because the society often castigates doubt on peer supporters. People do not believe that they peer supporters are capable of providing help to the patients since they have previously grappled with psychiatric disorders. What most people fail to acknowledge is that despite their past experience, the peer supporters are taken through rigorous training which equips them with diverse skills for delivering mental health care. Thornicroft & Slade (2014) report that peer supporters are trained on effective communication, problem-solving skills, leadership, effective decision-making, critical thinking as well as engagement. With these skills. The peer workers can facilitate interaction among patients and physicians and determine the challenges that affect the patients and the best ways of solving these challenges.
Stigmatization and prejudice in mentally ill patients
Often, most individuals who have been diagnosed with psychiatric disorders are challenged doubly. For instance, they struggle with the symptoms and disabilities of their mental illnesses. They also face the challenge of prejudice and stereotypes associated to the societal misconceptions of mental illnesses. With these, the patients end up being robbed the opportunity that defines a quality life such having a good job, safe housing, quality health care, and affiliation to various groups in the community. Other there has been thorough research aimed at understanding the impact of mental illnesses, little has been done to examine the impact of stigmatization towards mentally ill patients. Studies should focus on determining the scope of prejudice and stigma against persons with mental illnesses. It is commonly believed that stigmatization arises only from the community. However, this is not true as some health care providers also stigmatize patients. This can be seen in the manner in which they interact to the patients whereby some of them might be rude, reluctant to help the patients or dismiss the patients whenever they are approached. This greatly affects patients’ access to health care which may then worsen the prognosis of their illnesses.
More importantly, persons with psychiatric disorders are often kept in health centers, away from the community, for long periods. This is due to the stigmatizing belief that their treatment should be carried out in these facilities. The patients end up being alienated from the community making it difficult for them to resume their normal activities upon discharge. Stigmatization and prejudice creates feelings of hopelessness, low self-esteem, and disturbed though process. This state of mind can trigger feelings of depression and withdrawal which affects they treatment outcomes.
Causes of non-compliance, re-hospitalization in mentally ill patients
Loch (2012) argues that there is a high risk of re-hospitalization of mentally ill patients because most healthcare systems advocate for short hospital stays. This has been seconded by Michaels, López, Rüsch & Corrigan (2017) whose study points out that a large number of readmitted patients have psychiatric disorders with a range of between 22 to 80 percent. Re-hospitalization is a major source of suffering and frustration not only on patients but also their family members. More importantly, re-hospitalization affects healthcare systems as it increases the cost of care.
With regards to stigmatization and prejudice, re-hospitalization has been used as an important indicator of gauging if the society will accept persons with psychiatric disorders as well as an indicator for quality mental care services.
A study by Šprah, Dernovšek, Wahlbeck & Haaramo (2017) suggest that the risk of readmission may depend on three factors, that is adherence, stigma, or severity of mental illness. Patients who do not adhere to their medication guidelines are often readmitted shortly after their discharge. This has been proven among patients who report to health facilities without taking their medication but then the admission and restoration of adherence during their hospital stay protects them against the risk of future hospitalization hence non-adherence becomes a protective factor.
Research Questions
Various research questions were used in the selected articles depending on the aim of the study. For example, the research question in a study carried out by Chinman et al. (2014) was, “what is the effectiveness of peer support services in patients with mental illness?” Another example of a research question was, “how can peer-to-peer connections among persons with psychiatric disorders promote efforts of mental and physical wellbeing?” Jaramillo-Gonzalez, Sanchez-Pedraza & Herazo (2014) also conducted a study whereby one of their research questions was, “what is the frequency of re-hospitalization among psychiatric patients and what were some of the associated factors of this re-hospitalization?
Sample populations used
The studies selected used various sample populations depending on the nature of the study. Most of the studies targeted patients with mental illnesses who were admitted in various clinical settings. For instance, a study by Loch (2012), was conducted in Sao Paulo, Brazil where 169 participants with psychotic and bipolar disorders in need of hospitalization in public health centers were followed up 12 months after their discharge. The follow up was done through use of telephones whereby their family members were contacted.
Another study was done by (Jaramillo-Gonzalez, Sanchez-Pedraza & Herazo, 2014) and targeted patients who were hospitalized at Our Lady of Peace Clinic in Colombia which attends to adult patients with different mental disorders.
One of the studies that was quite unique is that of Naslund, Aschbrenner, Marsch & Bartels (2016) which targeted social media users on Facebook, Twitter, and YouTube. The study was based on the concept that most individuals with serious mental illnesses tend to increasingly turn to popular social media platforms where they share their experiences and seek advice from other users who could be suffering from similar disorders.
Limitations of the studies
The primary challenge that was is associated to the studies is the fact that it involved a sensitive group of individuals. Mentally ill patients just like children and prisoners are classified as sensitive groups by the Institution Review Board (IRB), and therefore, approval must be sought before conducting research. Most of the approvals take some time before being granted. Some studies also involved seeking responses from mentally ill patients. This was a challenge since some responses could not be credible, and therefore, may result in wrong conclusions. A study by (Naslund, Aschbrenner, Marsch & Bartels, 2016) depended on responses from social media users who were suffering mental disorders. However, not all responses could be credible since there was no real proof that the respondents were mentally ill as some participants could take part in the study yet they had no mental illness.
Conclusion
Patients with mental disorders can benefit greatly from peer support services. Well integrated peer support can result in a decrease in mental health symptoms as well as hospital visits. The patients’ self-esteem and hope is also likely to be boosted through peer support services. Their participation the community and social support from other community members is also expected to improve. More importantly, peer support is likely to reduce the risk of readmissions, decrease patient costs as well as health care costs that are associated with hospital readmissions.
Conversely, stigmatization and prejudice can compel the patients to shy away from seeking health care. It also worsens their prognosis as other symptoms such as depression and hopelessness tend to affect stigmatized patients.
Recommendations
Mental care stakeholders should acknowledge the impact of peer support in management of mentally ill patients and establish peer support programs throughout the country.
Peer support workers should be trained thoroughly so that they can have sufficient skills and knowledge for handling mentally ill patients. Their training can be based on educational programs that are based on evidence-based practices.
Moreover, persons with mental illnesses require quality care, and therefore, during therapeutic communication physicians should acknowledge the tough experiences that the patients are going through. With this in mind, they can then use different communication methods to encourage the patients with the most significant method being exercising respecting and understanding towards the patients. Understanding and respect will help the patients to comply to prescribed treatment plans hence reducing their likelihood of relapse.
References
Chinman, M., George, P., Dougherty, R. H., Daniels, A. S., Ghose, S. S., Swift, A., & Delphin-Rittmon, M. E. (2014). Peer support services for individuals with serious mental illnesses: assessing the evidence. Psychiatric Services, 65(4), 429-441.
Jaramillo-Gonzalez, L. E., Sanchez-Pedraza, R., & Herazo, M. I. (2014). The frequency of rehospitalization and associated factors in Colombian psychiatric patients: a cohort study. BMC psychiatry, 14(1), 161.
Loch, A. A. (2012). Stigma and higher rates of psychiatric re-hospitalization: São Paulo public mental health system. Revista Brasileira de Psiquiatria, 34(2), 185-192.
Mahlke, C. I., Priebe, S., Heumann, K., Daubmann, A., Wegscheider, K., & Bock, T. (2017). Effectiveness of one-to-one peer support for patients with severe mental illness–a randomised controlled trial. European Psychiatry, 42, 103-110.
Michaels, P. J., López, M., Rüsch, N., & Corrigan, P. W. (2017). Constructs and concepts comprising the stigma of mental illness. Psychology, Society, & Education, 4(2), 183-194.
Naslund, J. A., Aschbrenner, K. A., Marsch, L. A., & Bartels, S. J. (2016). The future of mental health care: peer-to-peer support and social media. Epidemiology and psychiatric sciences, 25(2), 113-122.
Repper, J., Aldridge, B., Gilfoyle, S., Gillard, S., Perkins, R., & Rennison, J. (2013). Peer support workers: Theory and practice. London: Centre for Mental Health.
Šprah, L., Dernovšek, M. Z., Wahlbeck, K., & Haaramo, P. (2017). Psychiatric readmissions and their association with physical comorbidity: a systematic literature review. BMC psychiatry, 17(1), 2.
Thornicroft, G., & Slade, M. (2014). New trends in assessing the outcomes of mental health interventions. World Psychiatry, 13(2), 118-124.
Walker, G., & Bryant, W. (2013). Peer support in adult mental health services: A metasynthesis of qualitative findings. Psychiatric Rehabilitation Journal, 36(1), 28.
Evidence-based practice (EBP) entails implementation of findings of research that is well conducted. It is for these reason that nurses should have the skills for properly critiquing research articles before arrive on the most suitable article. For this to be done, nurses should first understand the difference between reliability and validity of research articles. Often, these terms, reliability and validity, are used interchangeably. However, there is a great difference between them. For instance, reliability is the measure of stability or consistency of research findings (Cypress, 2017). One can think of it as the ability for research findings to be repeatable. A good example of a reliable tool is a medical thermometer which gives the correct temperature whenever it is used or a mathematical test which will accurately gauge the mathematical knowledge for every learner that takes it. Similarly, research findings should be reliable in that if a certain study indicates that use of peer support services among mentally ill patients has positive outcomes, the subsequent research articles should also show consistent findings for the recommendation of the study to be adopted in any health center.
Conversely, validity represents the extent to which a concept is accurately measured. All factors should be taken into consideration when conducting a study. Validity involves elimination of biases that may result in over-interpretation under-estimation of results (Spiers, Morse, Olson, Mayan & Barrett, 2018). For example, a study which is aimed at exploring depression but ends up measuring anxiety cannot be considered to be valid at all.
Why the reliability and validity of a study is important for translation
Reliability and validity are important parameters of any study. During translation, reliability is considered to ensure that the research articles that have been selected are reporting similar research findings. It can be detrimental for clinicians to adopt research findings from studies that have contradicting study outcomes.
Validity of research studies should also be examined. Nurses should look at the study sample and the environment and compare it to their own institution. If the nature of the study is similar to that of nurses’ environment, then they can adopt the suggested recommendations in their institution.
References
Cypress, B. S. (2017). Rigor or reliability and validity in qualitative research: Perspectives, strategies, reconceptualization, and recommendations. Dimensions of Critical Care Nursing, 36(4), 253-263.
Spiers, J., Morse, J. M., Olson, K., Mayan, M., & Barrett, M. (2018). Reflection/Commentary on a Past Article:“Verification Strategies for Establishing Reliability and Validity in Qualitative Research” http://journals. sagepub. com/doi/full/10.1177/160940690200100202. International Journal of Qualitative Methods, 17(1), 1609406918788237.
Before selecting a qualitative or quantitative resources, it is important for one to understand the difference between these two terms. This is because most people who undertake a research projects find it difficult to separately. Qualitative research aims at gaining understanding of the underlying opinions, reasons as well as motivations. It offers insights into problems and helps in developing hypothesis for potential quantitative studies. Conversely, quantitative studies are used to generate numerical data which can be transformed into usable statistics (Brannen, 2017). It quantifies opinions, attitudes, behaviors, and other variables.
When selecting qualitative articles, one should consider the study population, the study tool that was used, and the method of analyzing data. Examples of qualitative study tools include interviews, questionnaires, discussions, and observations (Bryman, 2017). One should therefore go for research articles whose tools are easy for them to interpret. The method of data analysis is also a parameter that one should consider. In that, an individual should opt for articles whose method of data analysis is easy to comprehend. Other important parameters that influence the choice of qualitative articles include the year of publication, the qualifications of the authors, and if the articles are peer reviewed. Articles should be recent, relevant, and written by individuals who are qualified in the field being studied. Having peer reviewed articles is also an advantage since it shows the validity of the articles has been scrutinized by trained professionals.
With regards to quantitative research, the sample size should be sizable for the research to comprehend. The method of data analysis should also be easy to understand. Just like in qualitative research, the year, qualification of authors, and if the articles are peer reviewed are other parameters that are considered.
For my study, I will choose the qualitative method of study because of the nature of my study. The study aims at determining the impact of peer support on mentally ill patients. Qualitative study will help in understanding the opinions and views of the patients and the family members.
References
Brannen, J. (2017). Mixing methods: Qualitative and quantitative research. Routledge.
Bryman, A. (2017). Quantitative and qualitative research: further reflections on their integration. In Mixing methods: Qualitative and quantitative research (pp. 57-78). Routledge.