Evidence-Based Critical Appraisal Research Paper

Evidence-Based Critical Appraisal Research Paper

Evaluation Table

Use this document to complete the evaluation table requirement of the Module 4 Assessment, Evidence-Based Project, Part 3A: Critical Appraisal of Research

Full APA formatted citation of selected article. Article #1 Article #2 Article #3 Article #4
Mejia-Lancheros, C., Lachaud, J., O’Campo, P., Wiens, K., Nisenbaum, R., Wang, R., … & Stergiopoulos, V. (2020). Trajectories and mental health-related predictors of perceived discrimination and stigma among homeless adults with mental illness. PloS one, 15(2), e0229385. https://doi.org/10.1371/journal.pone.0229385 Evidence-Based Critical Appraisal Research Paper

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Werremeyer, A., Mosher, S., Eukel, H., Skoy, E., Steig, J., Frenzel, O., & Strand, M. A. (2021). Pharmacists’ stigma toward patients engaged in opioid misuse: When “social distance” does not mean disease prevention. Substance Abuse, 42(4), 919-926. https://doi.org/10.1080/08897077.2021.1900988 Waqas, A., Malik, S., Fida, A., Abbas, N., Mian, N., Miryala, S., … & Naveed, S. (2020). Interventions to reduce stigma related to mental illnesses in educational institutes: a systematic review. Psychiatric Quarterly, 91(3), 887-903. https://doi.org/10.1007/s11126-020-09 Al Saif, F., Al Shakhoori, H., Nooh, S., & Jahrami, H. (2019). Association between attitudes of stigma toward mental illness and attitudes toward adoption of evidence-based practice within health care providers in Bahrain. PloS one, 14(12), e0225738. https://doi.org/10.1371/journal.pone.0225738 Evidence-Based Critical Appraisal Research Paper

Evidence Level *
(I, II, or III)
Level III Level III Level I Level III
Conceptual Framework

Describe the theoretical basis for the study (If there is no one mentioned in the article, say that here).**
The article uses the Group-Based Trajectory Model framework to evaluate discrimination and stigma, trajectory groups.

No conceptual framework The matching and distillation framework No conceptual framework
Design/Method

Describe the design and how the study was carried out (In detail, including inclusion/exclusion criteria). Home/Chez Soi randomized trial
Inclusion Criteria- Must be 18 years and homeless
Exclusion Criteria- individuals with mental illnesses but with no substance abuse The study involves a survey on social distance.
Inclusion: Must be a pharmacist
Exclusion: Experience with a vignette patient
The study involved randomized controlled trials to evaluate the impact of educational institutes on anti-stigma interventions.
Inclusion: Must have been within the eight selected databases, entail stigma topic, and the study design needed to be a randomized controlled trial.
Exclusion: Articles titles and abstracts The study engaged a cross-sectional study.
Inclusion: the healthcare providers needed to be from primary care and mental health services.
Exclusion: The mental health services participants were from the country’s main psychiatric hospital
Sample/Setting Evidence-Based Critical Appraisal Research Paper

The number and characteristics of
patients, attrition rate, etc. 414 participants with discriminatory and stigma trajectories

One hundred eighty-seven participants to evaluate the frequency and likelihood of social distance. Engaged 44 randomized controlled trial articles out of the 978 non-duplicated articles initially identified. Five hundred forty-seven health care providers, with 273 being primary caregivers while 274 being from the mental health services.
Major Variables Studied

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List and define dependent and independent variables Dependent Variables- Discrimination and Stigma
Independent Variables- homelessness and mental disorders
Dependent variable- Opioid patients
Independent Variable- Pharmacists’ Social distance Dependent Variable-Public stigma
Independent variable- anti-stigma interventions
Student perceptions Dependent Variables- Mental ill patients
Independent variables- Clinician’s stigma attitudes
Measurement Evidence-Based Critical Appraisal Research Paper

Identify primary statistics used to answer clinical questions (You need to list the actual tests done). Outcome and mental health measures to identify unfair treatment due to a patient’s mental disorder Social distance scale, Attitudinal, and demographics measurements. The measurement involved psycho-education and contact-based learning.
The study engaged the Evidence-Based Practice Attitude Scale (EBPAS) and OMS-HC in measuring the level of stigma among clinicians.
Data Analysis Statistical or
Qualitative findings

(You need to enter the actual numbers determined by the statistical tests or qualitative data). Ethno-racial status and discrimination history within the healthcare environment led to either high or low stigma trajectory group 59% of respondents showed the existence of an SDS score The above measurement led to an improvement of various factors, including; stigma by 76%, Help-seeking by 72%, attitude by 72%, and social distance by 57 among healthcare students. No statistical difference between the two scales since they resulted in (p = 0.146)
Findings and Recommendations
General findings and recommendations of the research Adults with mental health and homelessness face stigma and discrimination, thus the need to engage effective policies to intervene in the condition. Social distance leads to a reduction in engaging the patients in therapeutic relationships. Anti-stigma interventions among clinical students are essential. There were varying stigma levels for individuals that engaged in EBPAS, thus the need for the healthcare sector to engage in evidence-based practices. Evidence-Based Critical Appraisal Research Paper
Appraisal and Study Quality

Describe the general worth of this research to practice.

What are the strengths and limitations of the study?

What are the risks associated with the implementation of the suggested practices or processes detailed in the research?

What is the feasibility of use in your practice? The study is effective since it will reduce stigma and discrimination among the homeless patient population, thus no risk in implementing the policy, and it is viable in my practice to ensure healthcare professionals uphold work ethics to improve patient outcomes. The study is relevant since it helps identify the gap between pharmacists and opioid use patients. The policy is not inclusive since it involves only pharmacists with less than ten years of opioid use disorder since those with over ten years also need refresher courses on how to deal with the issue. The study’s strength lies in its objectivity in evaluating various factors that help in reducing both self and public stigma. Hence, the study is essential to help healthcare educators formulate better ways to administer psycho-education. The study is effective since it proves the need to engage in evidence-based practices within healthcare for better patient outcomes. Evidence-Based Critical Appraisal Research Paper

Key findings

Various Mental disorders like major depressive disorder and suicide expose patients to stigma and discrimination. Pharmacists did not see any issue performing their pharmacy duties to the opioid patients through social distance always happens when needed to form therapeutic relationships. Anti-stigma interventions help improve understanding concerning beliefs, attitudes, and mental health literacy. Mental health services participants had limited stigma instances compared to the participants from primary care services.

Outcomes

Need to engage in better strategies rather than housing first treatment. Such factors may increase cases of discrimination and stigmatizing opioid use patients. Such factors may lead these healthcare providers to support mental health patients to reduce the stigma impact on patient outcomes. There is a need to let the mental health department deal more with mental health issues for better patient outcomes.
General Notes/Comments There is a need to implement policies for homeless people with mental disorders.

Pharmacists need training to effectively know how to handle opioid use patients. More strategies to improve healthcare student perception before transitioning are essential. There is a need to establish more mental health care services to improve mental health patient well-being. Evidence-Based Critical Appraisal Research Paper

Part B
The article review has integrated the work from Mejia-Lancheros et al. (2020), Werremeyer et al., 2021, Waqas et al. (2020), and Al-Saif et al. (2019). All the authors provide an effective solution to answering the stigmatization question among mental health patients. However, Al-Saif et al. (2019) recommended engaging the mental health sector instead of the primary care services as an effective intervention toward mental health patients’ stigmatization and discrimination within the healthcare environment. According to Fineout-Overholt et al. (2010), evidence-based practices are essential within the healthcare industry, considering that the practice helps eliminate subjectivity within research. For instance, the Al-Saif (2019) study uses two measures, one based on the Opening Minds Scale for Health Care Providers and the Evidence-Based Practice Attitude Scale. As a reader, one ascertains that the results obtained from the research are objective and reliable to be applied in the physical clinical environment (Melnyk & Fineout-Overholt, 2018). Hence, Al-Saif et al. (2019) suggest that mental healthcare providers have lower chances of subjecting mental health patients to discrimination is enough proof to show that the governments must liaise with the healthcare leaders. That way, they will design better ways to improve the number of mental health care services. The reason for that is based on the fact that due to discrimination, many mental health patients may not seek healthcare services, thus deteriorating their conditions (Yin et al., 2020). For instance, in a study by Grasser (2022), over 27 million Americans have untreated mental disorders. For instance, by 2020, approximately 52.9 million adults in the United States had mental health conditions, with about 14.2 experiencing serious mental illnesses. Hence, some mental illnesses affect the patients’ behaviors, including violent and increased suicidal thoughts. Therefore, it is essential to ensure that the healthcare sector introduces more mental health services to encourage more patients to seek health services to benefit society and their well-being. Evidence-Based Critical Appraisal Research Paper

References

Al Saif, F., Al Shakhoori, H., Nooh, S., & Jahrami, H. (2019). Association between attitudes of stigma toward mental illness and attitudes toward adoption of evidence-based practice within health care providers in Bahrain. PloS one, 14(12), e0225738. https://doi.org/10.1371/journal.pone.0225738
Fineout-Overholt, E. , Melnyk, B. M. , Stillwell, S. B. & Williamson, K. M. (2010). Evidence-Based Practice, Step by Step: Critical Appraisal of the Evidence: Part II. AJN, American Journal of Nursing, 110 (9), 41-48. doi: 10.1097/01.NAJ.0000388264.49427.f9.
Grasser, L. R. (2022). Addressing mental health concerns in refugees and displaced populations: is enough being done?. Risk management and healthcare policy, 15, 909. doi: 10.2147/RMHP.S270233
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
Mejia-Lancheros, C., Lachaud, J., O’Campo, P., Wiens, K., Nisenbaum, R., Wang, R., … & Stergiopoulos, V. (2020). Trajectories and mental health-related predictors of perceived discrimination and stigma among homeless adults with mental illness. PloS one, 15(2), e0229385. https://doi.org/10.1371/journal.pone.0229385
Waqas, A., Malik, S., Fida, A., Abbas, N., Mian, N., Miryala, S., … & Naveed, S. (2020). Interventions to reduce stigma related to mental illnesses in educational institutes: a systematic review. Psychiatric Quarterly, 91(3), 887-903. https://doi.org/10.1007/s11126-020-09
Werremeyer, A., Mosher, S., Eukel, H., Skoy, E., Steig, J., Frenzel, O., & Strand, M. A. (2021). Pharmacists’ stigma toward patients engaged in opioid misuse: When “social distance” does not mean disease prevention. Substance Abuse, 42(4), 919-926. https://doi.org/10.1080/08897077.2021.1900988
Yin, H., Wardenaar, K. J., Xu, G., Tian, H., & Schoevers, R. A. (2020). Mental health stigma and mental health knowledge in Chinese population: a cross-sectional study. BMC psychiatry, 20(1), 1-10. https://doi.org/10.1186/s12888-020-02705-x

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. Evidence-Based Critical Appraisal Research Paper

THIS WILL BE THIS ASSIGNMENT>>>>>> Part 3B: Critical Appraisal of Research. YOU WILL UTILIZE PART 3A TO COMPLETE PART 3B

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.

8 RESOURCES – 4 ARTICLES, 2 OUTSIDE RESOURCES THAT SUPPORT and at least two course resources

Williamson, K. M. (2009). Evidence-Based Practice: Critical Appraisal of Qualitative Evidence. Journal of the American Psychiatric Nurses Association, 15(3), 202–207. https://doi.org/10.1177/1078390309338733

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

Chapter 5, “Critically Appraising Quantitative Evidence for Clinical Decision Making” (pp. 124–188)
Chapter 6, “Critically Appraising Qualitative Evidence for Clinical Decision Making” (pp. 189–218)

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Fineout-Overholt, E. , Melnyk, B. , Stillwell, S. B. & Williamson, K. M. (2010). Evidence-Based Practice Step by Step: Critical Appraisal of the Evidence: Part I. AJN, American Journal of Nursing, 110 (7), 47-52. doi: 10.1097/01.NAJ.0000383935.22721.9c.

Fineout-Overholt, E. , Melnyk, B. M. , Stillwell, S. B. & Williamson, K. M. (2010). Evidence-Based Practice, Step by Step: Critical Appraisal of the Evidence: Part II. AJN, American Journal of Nursing, 110 (9), 41-48. doi: 10.1097/01.NAJ.0000388264.49427.f9. Evidence-Based Critical Appraisal Research Paper