Critical Appraisal

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RUNNING HEAD: ASSIGNMENT 3
Appraisal 1

Critical Appraisal

by

Gemekia C. Parker

A Paper

Submitted in partial fulfillment of the requirements for

NU 608 EBP & Quality Improvement in Health Care Systems University of South

Alabama College of Nursing

Fall 2010

Appraisal 2

Introduction

Critical appraisal is the process of systematically examining research evidence to

assess its validity, results, and relevance. (Hill, 2001) Critical appraisal of research is preformed by clinicians prior to using it to make healthcare decisions. The critical appraisal process systematically finds, appraises, and acts on evidence based research after thorough review. The use of critical appraisal also allows us to make sense of research evidence and allows us to begin to close the gap between research and practice. (Hill, 2001)

The purpose of this paper is to critically appraise the levels of evidence in a meta-synthesis qualitative review and a systematic quantitative review. In completing this assignment, a basic understanding of the process of critical appraisal will be established. In addition, knowledge of the difference between a meta-synthesis qualitative review and systematic quantitative review will also be established. Qualitative Review

Qualitative research attempts to evaluate the underlying etiology of a proposed research question. Qualitative research provides insight to the setting of the problem and generates ideas for quantitative research.A qualitative review is intended to give an overview of previous studies that have been reported, regardless of statistical data. (Goethals, Sorenson, MacGregor,2004) Quantatative Review

Quantitative review provides a statistical analysis, thus providing a more concrete answer to the research question. (Goethals, Sorenson, MacGregor,2004)
Appraisal 3
For purposes of this paper, two articles have been selected and critically appraised based on their level of evidence. Dicenso, Guyatt and Ciliska (2005) has provided three steps in reviewing the article that are essential in critical appraisal. The three steps in reviewing a study include, determining the validity of the study results, determining the results, and determining how to apply the results to patient care. Critical Appraisal

The selected qualitative article for critical appraisal titled “A collaborative

approach to wellness: Diet, exercise, and education to impact behavior change” posed a

clearly focused research question. The purpose of this study was to evaluate a

multidisciplinary wellness program. The program was developed to help patients make

behavior changes necessary to help them loose weight. Four popular diets were selected

using a randomised controlled trial. Previous trials identified no significant

difference in weight loss when comparing the Atkins diet, Ornish diet, Weight Watchers,

and Zone diet. Advertisement of the wellness program was displayed throughout the

hospital, which provided a good basis for randomisation. Most of the participants were

referred by their provider, though some participants were selected in response to

invitational letters. A total of 109 “non-blinded”, overweight participants provided

feedback about their progress in the program. There was variance noted amongst all

participant level of success, though all 109 patients were accounted for at the end of the

study.
Results

Confirming the research question, implementation of a multidisciplinary

approach, using diet and exercise proved the most positive results. Higher rates of
Appraisal 4
weight loss was achieved in participants with higher attendance in regularly

scheduled exercise classes. Willingness to modify behavior, diet and exercise also

proved to be a major factor in the program.

Implications for practice:

While obesity continues to be major healthcare issues in...
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