Critical Appraisal of Research Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet T

4/7/23, 12:23 AM Module 4: Assignment

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Due Apr 16 by 10:59pm Points 100 Submitting a text entry box or a file upload Attempts 0 Allowed Attempts 2

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Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.

Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.

In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.

EVIDENCE-BASED PROJECT, PART 3: CRITICAL APPRAISAL OF RESEARCH

RESOURCES

4/7/23, 12:23 AM Module 4: Assignment

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To Prepare:

Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3. Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3. Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.

The Assignment (Evidence-Based Project)

Part 3A: Critical Appraisal of Research

Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.

Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.

Part 3B: Critical Appraisal of Research

Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.

Be sure to review the Learning Resources before completing this activity. Click the weekly resources link to access the resources.

WEEKLY RESOURCES (https://waldenu.instructure.com/courses/53151/modules/items/1043739)

BY DAY 7 OF WEEK 7

4/7/23, 12:23 AM Module 4: Assignment

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NURS_6052_Module04_Week07_Assignment_Rubric

Submit Part 3A and 3B of your Evidence-Based Project.

Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

1. To submit your completed assignment, save your Assignment as MD4Assgn+last name+first initial. 2. Then, click on Start Assignment near the top of the page. 3. Next, click on Upload File and select Submit Assignment for review.

SUBMISSION INFORMATION

4/7/23, 12:23 AM Module 4: Assignment

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Criteria Ratings Pts

45 pts

35 pts

Part 3A: Critical Appraisal of ResearchCritical Appraisal of Research Conduct a critical appraisal of the four peer-reviewed articles you selected and analyzed by completing the Critical Appraisal Tool Worksheet Template. Be sure to include: · An Evaluation Table

45 to >40.0 pts Excellent

The critical appraisal accurately and clearly provides a detailed evaluation table. …The responses provide a detailed, specific, and accurate evaluation of each of the peer-reviewed articles selected.

40 to >35.0 pts Good

The critical appraisal accurately provides an evaluation table. …The responses provide an accurate evaluation of each of the peer-reviewed articles selected with some specificity.

35 to >31.0 pts Fair

The critical appraisal provides an evaluation table that is inaccurate or vague. …The responses provide an inaccurate or vague evaluation of each of the peer-reviewed articles selected.

31 to >0 pts Poor

The critical appraisal provides an evaluation table that is inaccurate and vague or is missing.

Part 3B: Evidence-Based Best PracticesEvidence-Based Best Practices Based on your appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with the selected resources.

35 to >31.0 pts Excellent

The responses accurately and clearly suggest a detailed best practice that is fully aligned to the research reviewed. …The responses accurately and clearly explain in detail the best practice, with sufficient justification of why this represents a best practice in the field. …The responses provide a complete, detailed, and specific synthesis of

31 to >27.0 pts Good

The responses accurately suggest a best practice that is adequately aligned to the research reviewed. …The responses accurately explain the best practice, with adequately justification of why this represents a best practice in the field. …The responses provide an accurate synthesis of at least one outside resource reviewed on the best practice explained.

27 to >24.0 pts Fair

The responses inaccurately or vaguely suggest a best practice that may be aligned to the research reviewed. …The responses inaccurately or vaguely explain the best practice, with inaccurate or vague justification for why this represents a best practice in the field. …The responses provide a vague or inaccurate synthesis of outside resources reviewed on

24 to >0 pts Poor

The responses inaccurately and vaguely suggest a best practice that may be aligned to the research reviewed or are missing. …The responses inaccurately and vaguely explain the best practice, with inaccurate and vague justification for why this represents a best practice in the field or are missing. …A vague and inaccurate synthesis of no outside

4/7/23, 12:23 AM Module 4: Assignment

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Criteria Ratings Pts

5 pts

5 pts

the four peer reviewed articles.

the best practice explained.

resources reviewed on the best practice explained is provided or is missing.

Resource Synthesis 5 to >4.0 pts Excellent The response fully integrates at least two outside resources and two or three course-specific resources that fully support the responses provided.

4 to >3.0 pts Good The response integrates at least one outside resource and two or three course- specific resources that may support the responses provided.

3 to >2.0 pts Fair The response minimally integrates resources that may support the responses provided.

2 to >0 pts Poor The response fails to integrate any resources to support the responses provided.

Written Expression and Formatting —Paragraph Development and Organization:Paragraphs make clear points that support well- developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused— neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided, which delineates all required criteria.

5 to >4.0 pts Excellent Paragraphs and sentences follow writing standards for flow, continuity, and clarity. …A clear and comprehensive purpose statement, introduction, and conclusion are provided, which delineates all required criteria.

4 to >3.0 pts Good Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. …Purpose, introduction, and conclusion of the assignment are stated but are brief and not descriptive.

3 to >2.0 pts Fair Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60–79% of the time. …Purpose, introduction, and conclusion of the assignment is vague or off topic.

2 to >0 pts Poor Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. …No purpose statement, introduction, or conclusion is provided.

4/7/23, 12:23 AM Module 4: Assignment

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Total Points: 100

Criteria Ratings Pts

5 pts

5 pts

Written Expression and Formatting —English Writing Standards: Correct grammar, mechanics, and proper punctuation.

5 to >4.0 pts Excellent

Uses correct grammar, spelling, and punctuation with no errors.

4 to >3.0 pts Good

Contains a few (one or two) grammar, spelling, and punctuation errors.

3 to >2.0 pts Fair

Contains several (three or four) grammar, spelling, and punctuation errors.

2 to >0 pts Poor

Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

Written Expression and Formatting:The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.

5 to >4.0 pts Excellent

Uses correct APA format with no errors.

4 to >3.0 pts Good

Contains a few (one or two) APA format errors.

3 to >2.0 pts Fair

Contains several (three or four) APA format errors.

2 to >0 pts Poor

Contains many (five or more) APA format errors.

The Mindfulness-Based Interventions in Reducing  Stress and Anxiety in Patients with Coronary Heart 

Disease

Adebusola Balogun

Walden University

Essentials of Evidence Base Practice

NURS 6052 

April 2nd, 2023.

 The chosen clinical issue is the effectiveness of  mindfulness-based interventions in reducing stress  and anxiety in patients with coronary heart disease.

 PICO(T) question:  ◦ P - Patients with coronary heart disease  ◦ I - Mindfulness-based interventions  ◦ C - Standard treatment or no treatment  ◦ O - Reduction in stress and anxiety  ◦ T - Time (length of follow-up)

Clinical Issue and PICOT Question

 The four Peer-reviewed research article databases  utilized include: ◦ PubMed ◦Walden University Library ◦ PsycINFO ◦ CINAHL

 The levels of evidence and strengths of using  systematic reviews are as described in the following  slides of the articles used in the review.

Article Databases, Levels of Evidence and Strengths

 The first article is a systematic review and meta-analysis of  randomized controlled trials (RCTs) that investigated the  effects of mindfulness-based interventions on stress and  anxiety in patients with coronary heart disease (O’Doherty, et  al., 2015). 

 This systematic review provides the highest level of evidence  and includes a comprehensive search strategy, a transparent  selection process, and a statistical synthesis of the results. 

 One of the strengths of using systematic reviews includes the  ability to synthesize and analyze data from multiple studies.

 Another strength is providing a more reliable estimate of the  treatment effect, and reducing the risk of bias.

Article 1

 The second article is an RCT that compared the effects of  a mindfulness-based stress reduction program to a control  group on patients with cardiovascular disease (Marino, et  al., 2021). 

 This study provides a high level of evidence and includes  a clear description of the intervention and outcome  measures.

 One of the strengths of using RCTs include the ability to  control for confounding variables and randomize  participants to treatment groups.

 Another strength is the ability to reduce the risk of bias.

Article 2

 The third article is a systematic review of RCTs that  investigated the effects of mindfulness-based  interventions on psychological outcomes in patients with  cardiovascular disease (Jalali, et al., 2019). 

 This review provides a high level of evidence and  includes a detailed search strategy and selection process. 

 One strength of using systematic reviews include the  ability to provide a more comprehensive overview of the  literature.

 Another strength of the article is the ability to identify  areas for future research.

Article 3

 The fourth article is a cross-sectional study that  investigated the association between mindfulness and  psychological distress in patients with cardiovascular  disease (Zou, et al., 2021). 

 This study provides a lower level of evidence compared  to RCTs and systematic reviews but can still provide  valuable insights. 

 One of the strengths of using cross-sectional studies  include the ability to collect data from a large number of  participants.

 Another strength is the ability of identifying potential  associations between variables.

Article 4

 Overall, the use of systematic reviews in clinical  research is important as it allows for the synthesis of  evidence from multiple studies.

 It reduces bias and provides a more reliable estimate  of the treatment effect. 

 Additionally, the use of RCTs and cross-sectional  studies can also provide valuable insights into the  effectiveness of mindfulness-based interventions in  reducing stress and anxiety in patients with coronary  heart disease.

Conclusions

 Jalali, D., Abdolazimi, M., Alaei, Z., & Solati, K. (2019). Effectiveness  of mindfulness-based stress reduction program on quality of life in  cardiovascular disease patients. IJC Heart & Vasculature, 23, 100356.

 Marino, F., Failla, C., Carrozza, C., Ciminata, M., Chilà, P., Minutoli,  R., … & Pioggia, G. (2021). Mindfulness-based interventions for  physical and psychological wellbeing in cardiovascular diseases: A  systematic review and meta-analysis. Brain Sciences, 11(6), 727.

 O’Doherty, V., Carr, A., McGrann, A., O’Neill, J. O., Dinan, S.,  Graham, I., & Maher, V. (2015). A controlled evaluation of  mindfulness-based cognitive therapy for patients with coronary heart  disease and depression. Mindfulness, 6, 405-416.

 Zou, H., Cao, X., & Chair, S. Y. (2021). A systematic review and  meta‐ analysis of mindfulness‐ based interventions for patients with  coronary heart disease. Journal of Advanced Nursing, 77(5), 2197- 2213.

REFERENCES

1

Clinical Issue Identified: Causes of Heart Disease among the Elderly Population

Adebusola Balogun

Walden University

Essentials of Evidence-Based Practice

NURS 6052

March 19th, 2023.

2

Clinical Issue Identified: Causes of Heart Disease among the Elderly Population

Relevant Peer Reviewed Articles from Walden Library

Fuchs, F. D., & Whelton, P. K. (2020). High blood pressure and cardiovascular disease.

Hypertension, 75(2), 285-292.

https://doi.org/10.1161/HYPERTENSIONAHA.119.14240

Groenewegen, A., Rutten, F. H., Mosterd, A., & Hoes, A. W. (2020). Epidemiology of heart

failure. European journal of heart failure, 22(8), 1342-1356.

https://doi.org/10.1002/ejhf.1858

Hayes, R. B., Lim, C., Zhang, Y., Cromar, K., Shao, Y., Reynolds, H. R. … & Thurston, G. D.

(2020). PM2. 5 air pollution and cause-specific cardiovascular disease mortality.

International journal of epidemiology, 49(1), 25-35. https://doi.org/10.1093/ije/dyz114

Jankowski, J., Floege, J., Fliser, D., Böhm, M., & Marx, N. (2021). Cardiovascular disease in

chronic kidney disease: pathophysiological insights and therapeutic options. Circulation,

143(11), 1157-1172. https://doi.org/10.1161/CIRCULATIONAHA.120.050686

Each Study Results from Review

The first study in the list masks the overall cardiovascular disease picture. The results in

this article indicated that the right-sided population shift in blood pressure distribution causes

cardiovascular disease. The study demonstrated less rise in blood pressure with aging, more so

among the Indian communities in Brazil who had minimal salt. The findings indicated that BP

would reduce vascular effects associated with aging (Fuchs & Whelton, 2020). Cohort studies in

this study showed that high blood pressure is a vital risk factor for dementia, heart failure, aortic

syndromes, atrial fibrillation, heart valve disease, and chronic kidney disease.

3

The second research article's findings indicate a slow decline in heart failure and that the

mortality rate associated with heart failure is rising among individuals living in low-income

countries because of the western lifestyle and the communicable diseases' double burden

(Groenewegen et al., 2020). The results show that although the number of mixed heart failure

incidences has reduced among the young, there are still opposite trends thought to be caused by

obesity.

The third study results show that increased particulate matter by 10 milligrams per square

meter with completely adjusted models increased ischemic heart disease mortality by 16% and

stroke-related mortality by 14%. The results indicated little difference in the exposure found in

factors such as marital status, tobacco or alcohol use, sex, body mass index, and education,

unlike in the racial factor, where the non-Hispanic blacks showed the highest exposure.

The fourth article summarizes the cardiovascular disease clinical consequences in chronic

kidney disease (CKD). Results showed that nearly all the patients with stage 4 and 5 CKD

exhibit cardiovascular heart disease, and between 40% to 50% of the cardiovascular heart

disease-associated deaths have CKD. As indicated in the results, the CKD effect on

cardiovascular heart disease was not neutralized by the more than 70 studies' non-dialyzed

individuals.

Reflection on the Unfiltered Database Use to Search for the Articles

It took much work to search the articles from the unfiltered databases compared to

searching for peer-reviewed articles from databases whose filters are complete and the option to

put the query in the manner I wish to. This gave me an open eye on the literature search and

enabled me to critically and keenly find relevant articles depending on the clinical issue selected.

The search activity was fun, even though it was time-consuming.

4

Research Methodologies' Reflection for Each Article

The first study utilized cohort studies' randomized controlled trials and meta-analysis as

the research design. The second research study used echocardiographic screening meta-analysis

studies. The methodology employed in the third study is descriptive statistics with a Cox

regression base model. The fourth study utilized a meta-analysis methodology.

Analysis of Methodologies Used in the Peer-Reviewed Articles

I chose this article because it focuses on identifying the causes of heart disease, including

high blood pressure that it identifies. The national institute also approves general medical

services. This study aimed to determine how blood pressure shift affects cardiovascular disease.

The research methodology utilized was a meta-analysis which is a mixed-method approach. The

strength of the research article involved the pooling of data from many cohort studies, and that

means that the accuracy of the results obtained is high. This makes the method utilized in this

reliable.

The second article utilized meta-analysis with cohort studies applied to a population,

including the Chicago heart cohort and cardiovascular heart study. This study aimed at ambulant

patients' characteristics with heart failure with reduced registry studies based on the geographical

region. It focused on identifying the causes based on the region and income level. The

methodology is reliable because it uses study samples from different continents, and the results

can be generalized. The strength of this study is that it was well-funded by the Dutch heart

foundation.

The descriptive statistics methodology was used in the third article. It included using a

baseline questionnaire for medical history, diet, and physical activity. The mailing of the

questionnaire to 3.5 million and getting answers from 566398 makes these results generalizable

5

and, in turn, reliable because the sample is representative (Hayes et al., 2020). The strength of

this study is that it obtained data from a large sample and used a single point, the email, to collect

data from the participants using the questionnaire. This study aims to find out the risk of ambient

air pollution to cardiovascular disease at exposure to particulate matter at low levels in the

United States of America and other places.

The fourth article utilised the meta-analysis methodology to demonstrate the exponential

death risk increase with decreased functioning of the kidney in determining the relationship

between risk for all causes of cardiovascular mortality and non-dialyzed-dependent chronic

kidney disease. The results from this study and the method used are reliable because they

involved more than 1.4 million participants (Jankowski et al., 2021). The large sample size of

1,371,990 patients remains the strength of this article because the results obtained can be

generalized. Further, the greater the sample, the higher the accuracy of the findings. This study

aimed at finding out whether the risk of developing the cardiovascular disease for patients with

chronic kidney disease is higher than that of reaching end-stage kidney disease.

6

References

Fuchs, F. D., & Whelton, P. K. (2020). High blood pressure and cardiovascular disease.

Hypertension, 75(2), 285-292.

https://doi.org/10.1161/HYPERTENSIONAHA.119.14240

Groenewegen, A., Rutten, F. H., Mosterd, A., & Hoes, A. W. (2020). Epidemiology of heart

failure. European journal of heart failure, 22(8), 1342-1356.

https://doi.org/10.1002/ejhf.1858

Hayes, R. B., Lim, C., Zhang, Y., Cromar, K., Shao, Y., Reynolds, H. R. … & Thurston, G. D.

(2020). PM2. 5 air pollution and cause-specific cardiovascular disease mortality.

International journal of epidemiology, 49(1), 25-35. https://doi.org/10.1093/ije/dyz114

Jankowski, J., Floege, J., Fliser, D., Böhm, M., & Marx, N. (2021). Cardiovascular disease in

chronic kidney disease: pathophysiological insights and therapeutic options. Circulation

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