Research Article Critique, Part 2

Occupational Stressors, Stress Perception Levels, and Coping Styles of Medical Srugical RNs: A Generalized Perspective

(Wakim, 2014)

 

 

Your assigned article for critique is:

Wakim, N. (2014). Occupational stressors, stress perception levels, and coping styles of medical surgical RNs. Journal of Nursing Administration, 44(12), 632-639. doi:10.1097/NNA.0000000000000140

 

 

Instructions:  A major skill that is learned in this course is how to critically read and critique nursing research articles.  The purpose for critiquing an article is to critically evaluate the research process followed by the author(s) of the assigned article. This is an information-intensive, time-intensive process that is not learned overnight.   To demonstrate your skill at critiquing an article, you will complete this open-book multiple choice assignment.

Here’s how you should approach completing this week’s assignment to finish critiquing an article:

1.  First, do your assigned reading in Grove, Gray, and Burns (2015) and complete the reading worksheets early in the week.  This will introduce you to the critique skills you will need for the week.

2.  Skim the entire instructor assigned research article that has been posted on Blackboard for you so that you will have an idea of what it is about.  Lightly cross out the abstract for the article (you won’t be using it). Then, for this week, re-read carefully from the study design section through the end of the article.

3.  Print this document and find the best answer to each question below based on your Grove, Gray, and Burns (2015) assigned reading for the week and what you have read in the instructor assigned research article.

4.  Some of the questions in the critique assignment below will seem unfamiliar to you. Look up key terms from the question in your textbook.  Some examples of these terms might be: power analysis, inter-rater reliability, and generalization. You can also look in Chapter 12 for an example of a critical appraisal (or critique) of a quantitative research article.

5. Once you have completed this assignment “on paper”, go into blackboard and enter your answers by the assignment due date and time listed in the syllabus.  Ignore any wording from Blackboard that indicates that “this is a test” and carefully enter your answers from this document.

6.  You will have two access attempts to record your answers.  This is given to you so that if you encounter technical difficulties on your first attempt, or you would like a second attempt to try to improve your grade, you may do so.  You will not be able to see the questions that you missed when you submit your attempt.  Blackboard will record the highest grade from the two submissions.

If you have questions about this assignment, you can post them to your group discussion board for help.  Please do not post the exact question from the assignment below and ask the group for the answer as this would constitute academic dishonesty.

Questions 1 – 9: Sample.  (For help with these questions, refer to chapters:  9 & 12)

1.  What sampling method or plan was used by the authors in this study?

a.   Simple random sampling

b.   Systematic sampling

c.   Convenience sampling

d.   Network sampling

 

2.  According to Grove, Gray, and Burns (2015), what are the potential biases of this sampling method?

a.   This is a strong probability sampling method with very little potential for bias

b.   This method is used when an ordered list of all members of the population are available, and provides a random but not equal chance for inclusion in the study.

c.   This method provides little opportunity to control for bias because subjects are included in the study merely because they happen to be in the right place at the right time.

d.   This method is specific to the individuals who were recruited and the information gained cannot be generalized to others who don’t share these types of experiences.

e.   None of the above biases best describe the sampling method chosen by the author.

 

3.  What was the final sample size reported by the authors for this study?

a.  200 participants

b.  84 participants

c.   159 participants

d.   161 participants

 

4.  Was a power analysis conducted?  If so, which statement best describes the results of the power analysis?

a.    The authors mention that an a priori power analysis was conducted, and 200 subjects were

determined to be needed for the study.

b.   The authors mention that a power analysis was conducted using four predictors and 1-way ANOVA using three independent groups for a needed sample size of 159.

c.   The authors do not report that a power analysis was conducted.

 

5.  Which of these statements would be considered an inclusion criterion for the sample in the research article?

a.   English-speaking

b.   Have at least two years of experience as a nurse

c.   Work on a Medical Surgical unit

d.   Be a member of the Medical Surgical Nurses Association

 

 

6.  Which of these statements would be considered to be exclusion criterion specifically identified by the author for the sample in the research article?

a.  The exclusion criteria were explained verbally during recruitment.

b.  History of depression/ mental health issue.

c.   Report of no stress related problems by the participant.

d.  Participants only worked on the night shift.

 

7.  What is the refusal rate for this study? (Hint: see page 253 in your text)

a.   161/200 X 100% = 80%

b.   84/159 X 100% = 53%

c.   unknown / cannot be calculated.

d.   39/200 x 100% = 19.5%

 

8.  Which of the following would be accurate for the attrition rate for this study?

a.   161/200  X 100% = 80%

b.   39/200 X 100% = 20%

c.   84/159 X 100% = 53%

d.   0%

 

9.   What was the setting for this research study?  Briefly describe the setting and indicate whether it was appropriate for conducting this study.

a.   The setting for this study was a partially controlled setting and was appropriate for this study’s research design.

b.   The setting for this study was not well described by the authors and therefore not appropriate for

conducting this study.

c.   The setting for this study was a highly controlled setting and was appropriate for this study’s research design.

d.   The setting for this study was a natural or field setting and was appropriate for this study’s research design.

 

Question 10 – 14: Measurement Methods.  (For help with these questions, refer to chapters 10 & 12.)

10.  Which ones of these questionnaires, scales, or physiologic measures is used in this research study?

(Select all that apply).

a.   The Ways of Coping Questionaire (WAYS)

b.  The Nursing Stress Scale (NSS)

c.   The Perceived Stress Scale (PSS)

d.   The Quality of Life Scale (QOLS)

 

11.  How do the authors describe the reliability of the Nursing Stress Scale (NSS) in previous studies?

a.   Two follow-up emails were sent to potential participants.

b.   they compared the odd and even questions on the test to determine their equivalence.

c.   a team of staff nurses was trained by the primary investigator to administer the questionnaire.

d.   they tested a group of subjects twice using the same questionnaire (test-retest reliability).

e. they computed a Cronbach’s alpha on the Nurse Stress Scale that was administered to this group of subjects.

 

12. How do the authors describe the validity of The Ways of Coping Questionnaire (WAYS).

a.    discriminant validity demonstrated that each subscale measured the same constructs.

b.   evidence of validity from contrasting groups because they gave it to spouses of MS nurses.

c.   no was no mention of determining the validity of WAYS questionnaire.

d.   The authors had experience with administering this questionnaire.

 

13.   What types of questionnaires or surveys were used in this research study?  (Select all that apply.)

a.  The authors developed the Professional Quality of Life Scale.

b.  Interviews were reportedly used, but the authors do not explain what was included in them.

c.  The authors developed their own questions to ask about demographic information.

d.   The authors report adding a few of their own questions at the end of the demographic questionnaire.

e.   This study did not use any questionnaires or surveys.

f.    The authors used previously developed questionnaires or surveys to measure the study

variables.

 

14.   Were any physiological measurements collected from the subjects for the purpose of this study?

a.   Yes

b.   No

 

Question 15- 16: Data Collection. (For help with these questions, refer to chapters 10 & 12)

 

15. Which one of the following best describes the data collection process used in this study?

a.   questionnaires / surveys were completed via the telephone.

b.   participants were given the questionnaires on enrollment in the study and asked to drop the sealed envelope in a locked box at the nurse’s station.

c.   questionnaires / surveys were mailed to the prospective participants and returned in a self-

addressed stamped envelope.

d.   nurse researchers interviewed the study participants in a focus group.

 

16.  If there were more than one data collector for the study, would an estimation of inter-rater reliability be an important concept for the authors to report on for this study?

a.   yes, and the authors reported their efforts to achieve inter-rater reliability.

b.   yes, but the authors do not discuss any efforts to achieve inter-rater reliability.

c.   no, the issue of inter-rater reliability does not apply here.

 

Question 17 – 19:  Data Analysis. (For help with these questions, refer to chapters 11 & 12)

17.  What descriptive statistics are used in this study?  (Select all that apply).

a.   mean

b.   median

c.   mode

d.   standard deviation

e.   z-scores

f.   percentage distributions

 

18.  What inferential statistics were used to examine the data obtained from the subjects?  (Select all that apply)

a.   Bivariate correlational analysis

b.   Factor Analysis

c.    t-Test

d.   Chi-Square

e.   ANCOVA

f.   ANOVA

g.   regression analysis

h.   None of the above inferential statistics were used in this study.

 

19.  What is the level of significance (alpha) set at for this study?

a.   .05 or 5%

b.   .10 or 90%

c    .01 or 1%

d.   an alpha level or level of significance chosen by the authors was not specifically mentioned in the text

of the article.

 

Question 20-25: Researcher’s Interpretation of the Findings. (For help with these questions, refer to chapters 11 & 12)

 

20.  There are several statistically significant findings in this study. Which of these statements from the article would be considered a significant and predicted result? (select all that apply)

a.   As MS nurses’ perceptions of their stress increases, their use of ways to cope increases (r = .357, P<.00)

b.   Younger nurses have lower levels of perceived stress, per post hoc Tukey analysis.

c.   Baby boomers tend to report higher use of self-controlling behaviors than Gen X and Gen Y nurses when dealing with occupational stressors.

d.  The stress perception level is thus determined by the type of occupational stressor that the nurse is

exposed to.

21.  Which of these statements from the article would be considered a non-significant result. (Select all that apply)

a.   The older the nurse, the higher the level of stress.

b.   There was no difference between the scores on ways of coping related to age cohorts (F₂₁₅₈ = 1.12, P=.33)

c.   Age, years of experience, and educational levels are not significant factors in levels of perceived stress among MS nurses.

              d.   Baby boomers tend to report higher use of self-controlling behaviors than Gen X and Gen Y nurses

when dealing with occupational stressors.

 

 

22.  Which one of these statements from the article would be considered clinically important?

a.    According to this study results, a high level of occupational stress is not a known factor for nursing

turnover in MS nurses.

b.   Younger nurses have better coping skills to combat perceived stress compared to more

experienced nurses.

c.   Baby boomers reported higher use of self-controlling behaviors when dealing with occupational

stressors compared with Gen X and Gen Y.

d.   Six participants were removed from the study due to incomplete surveys.

 

23.  Which statements below implied from the article would be considered a limitation of the study? (Select all that apply)

a.   The researchers utilized a qualitative method in the research design.

b.   Lack of standardization of the conditions of administering the instruments.

c.   A small sample size with a low response rate.

d.   A measure of social desirability in giving responses as the participants worked with the researcher.

 

24.  Which one of these statements would be considered a statement regarding generalization of these results?

a.   The results indicated that there were high levels of perceived stress in this group of MS nurses and can be generalized to all MS nurses in the United States.

b.   The survey was mailed only to MS nurses who were members of the Medical Surgical Nurses Association (MSNA).

c.    A convenience sample of MS nurses decreases generalizability.

d.    The use of a power analysis influenced the generalization of the results to all MS nurses.

 

 

25.  Which one of these statements from the article would be considered a recommendation for future studies?  (Select al that apply.)

a.   Future development of programs to help relieve the occupational stress in MS nurses.

              b.   Research to discover why older nurses have a higher perceived stress compared to younger nurses.

c.   Sufficiently educating nursing leaders in generational differences.

 

d.   Identification of occupational stressors, perceived stress, and coping styles among generational cohorts.

1. Plan of care, evaluation, subjective data, and objective data are all parts of

A. a telephone encounter.

B. documentation.

C. the progress note.

D. a clinic visit.

 

2. Mr. Smith has an appointment with Dr. Johnson at 9:00 A.M. for his annual wellness exam. Mrs. Adams calls the clinic first thing in the morning due to fever, chills, and cough for 3 days and is given an appointment at 9:00 A.M. with Dr. Johnson as well. This is an example of

A. overlap.

B. accommodating.

C. jamming.

D. double-booking.

 

3. A provider performs _______ to signify that everything in the note is correct.

A. technological signature

B. digital signature

C. annotation

D. autograph

 

4. Dan has made an appointment for review of his medication, as he recently relocated to the area with his family. Before his appointment, he has been asked to fill out and bring _______ form.

A. disclosure

B. health history

C. review of systems

D. consent

 

5. Incident reports are reviewed by the staff to aid in

A. policies.

B. prevention.

C. change.

D. procedures.

 

6. Which of the following is an appropriate way to reduce no-show appointments?

A. Ensure the patient writes down their appointment.

B. Perform reminder calls one to two days preceding the appointment.

C. There are no good ways to reduce no-shows.

D. Schedule all appointments within seven days of the appointment day.

 

7. A patient notes that they smoke a half a pack of cigarettes per day and drink a six pack of beer every night. Where would this be documented in the chart?

A. Medical history

B. Social history

C. Chief complaint

D. Problem list

 

8. Which of the following is not considered an integrated device?

A. Telephone

B. Signature pad

C. Scanners

D. Camera

 

9. _______ allows for disclosure of protected health information (PHI) through phone, fax, or email without specific patient authorization.

A. Confidentiality

B. HIPAA Security Rule

C. HIPAA Privacy Rule

D. Clinic policies and procedures

 

10. _______ is the most important responsibility of all members of the medical office.

A. Communication

B. Accountability

C. Documentation

D. Punctuality

 

11. All of the following require an incident report to be filed except

A. if the wrong patient is contacted for an appointment reminder.

B. if the employee suffers a needle stick.

C. if the wrong medication is administered to the patient.

D. if the patient falls in the hallway.

 

12. The process of a data code being unreadable until its destination is reach is called

A. cryptic.

B. jumble.

C. decryption.

D. encryption.

 

13. The _______ is a centralized location for a summary of a patient’s acute and chronic conditions.

A. chief complaint

B. medical history

C. disease list

D. problem list

 

14. Which of the following are not guidelines for proper telephone etiquette?

A. Answer by the third ring is possible

B. Answer with a pleasant greeting

C. Speak slowly and clearly

D. Keep a straight, professional face

 

15. Myrtle uses a cane to ambulate. She came to the clinic for an appointment, but before making it inside the building she tripped and fell on the curb. What type of document needs to be created?

A. Incident report

B. Fall report

C. Accident report

D. Injury report

 

16. Through the use of _______ a patient may view open appointments or schedule their own appointment.

A. patient access

B. patient flow

C. patient gateway

D. patient portal

 

17. Cindy has a hand-written fax number from a patient’s parent to fax a note to the school for use of a medication while at school. Cindy is unable to read all of the fax numbers. What should she do?

A. Avoid sending the note since the correct number wasn’t given

B. Call the patient to confirm the number

C. Send to the closest number

D. Ask other office staff

 

18. What’s the default landing page in SCMO when entering a patient encounter?

A. Allergies

B. Chief complaint

C. Vital signs

D. Progress note

 

19. _______ is a rundown of organ systems that can be used to pinpoint certain concerns or unusual findings.

End of exam

A. Review of systems

B. Report of symptoms

C. Report of systems

D. Review of symptoms

 

20. “It feels like an ice pick in my head” and “I’m coughing up a lung” are considered

A. chief complaints.

B. reason for visit.

C. presenting symptom.

D. medical concerns.

TO DO A REPLY COMMENT TO EACH POST. TWO REFERENCE PER COMMENT.

Post 1

Mental health processes and disorders originate from mechanisms within the brain. There has been the question within the psychiatric field as to whether plastic changes in the brain that can occur with the use of  pharmacological interventions for mental health disorders could also occur with the use of psychotherapy. Psychotherapy is extremely beneficial in treating several mental health issues (Laureate Education, 2016).There is compounding evidence that psychotherapy does have a biological basis and can have a positive impact in brain recovery from the stress response. According to Wheeler (2014), psychotherapy mediates the reintegration and connection of neural networks that have become maladaptively linked due to adverse life events facilitating healing of the brain. Psychotherapy has been found to be an effective treatment method for a variety of mental health disorders such as anxiety, major depression, and post-traumatic stress disorder. According to Fournier (2014), activity in regions associated with negative emotion, emotion regulation, fear, and reward are associated with respones to psychotherapy, and psychotherapy appears to alter the functioning of these regions.

While proven to be an effective treatment modality for mental health disorders, there are factors such as culture, religion, and socioeconomic background that can affect the client and their perspective on the use of psychotherapy. Psychotherapy within itself can bring conflicting emotions for the client and the clinician must be aware of how religion, culture, and socioeconomics can alter how the client perceives psychotherapy and its efficacy in their treatment. According to Wheeler (2014), the powerful influence of culture permeates all dimensions of out life in a way that is often unconscious. For example, if a client comes from a culture where emotions are not to be discusssed or if one discusses there past traumas or fears then the client could be resistant to the role of psychotherapy in their treatment plan. The clinician must be aware of the importance of culture in medical or psychological treatments. Religion also plays an instrumental role in how psychotherapy will be perceived by a client. Many clients may come from a religious background where one only speaks of negative emotions with someone from their clergy or a religious figure. According to Kim, Chen & Brachfeld (2018), religion and spirituality are important issues to consider and address in psychotherapy. Communication could become stagnant if the clinician is not aware of the role religion plays in the psychotherapy framework. Socioeconomic background can also be a variable in one‘s perspective of the value of psychotherapy. Certain traumatic events that a person can suffer throughout their lifetime can be directly correlated to socioeconomic standing. For example, poverty can be associated with depression, anxiety, substance abuse, and mood disorders. Patients from this type of background can experience barriers in both seeking and receiving mental health services. According to Bernal et al. (2017), vulnerable populations such as those low in social status face additional barriers to mental health treatment and experience unique barriers to receiving optimal care.

References

Bernal, D.R., Herbst, R.B., Lewis, B.L., & Feibelman, J. (2017). Ethical care for vulnerable populations receiving psychotropic treatment. Ethics & Behavior, 27(7), 582-598. doi:10.1080/10508422.2016.1224187

Fournier, J.C., & Price, R.B. (2014). Psychotherapy and neuroimaging. Psychotherapy: New Evidence and New Approaches, 12(3), 290-298. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4207360

Kim, E.E., Chen, E.C., & Brachfeld, C. (2018). Patients’ experience of spirituality and change in individual psychotherapy at a Christian counseling clinic: A grounded theory analysis. Spirituality in Clinical Practice, doi:10.1037/scp0000176

Laureate Education (Producer). (2016). Introduction to psychotherapy with individuals [Video file]. Baltimore, MD: Author.

Wheeler, K. (Eds.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.

POST 2

Psychotherapy is just as controversial as mental health as a whole is. Some believe it is helpful, others believe it is a waste of time. One question still remains unanswered for many, can talking about feelings help change behavior and therefore sure whatever condition a person is suffering from? I believe psychotherapy has a biological basis. Lyrakos, Spinaris, and Spyropoulos (2017) clearly stated as results of a research that “the use of psychotherapy plays a significant role in achieving optimal health outcomes of psychiatric patients” (p. s753). Pairing psychopharmacology with psychotherapy can make a positive impact towards recovery compared to treatment with just psychopharmacology.

Many different reasons can influence the belief that psychotherapy might or might not work. For example, Adams et al. (2017) concluded in an article that “findings suggest that patients’ attachment characteristics play a role in their views and choices regarding treatments” (p. 194). Other factors that can impact the belief that therapy is a waste of time are culture, religion, and socioeconomic status. A person’s upbringing can be one to avoid talking about feelings with a stranger, or even with a loved one. Religion can also play a role in not receiving this type of treatment as faith in a spiritual belief might be the perceived as the cure to an ailment. Economical status and education level can also negatively impact the decision to avoid this type of treatment as the importance of it might not be completely comprehended or there are no means to afford the treatment. In another study that correlates the importance of psychotherapy, data showed “that children/adolescents with not only behavioral and emotional disorders, but also affective (mood) disorders had a higher chance for nondrug psychiatric/psychotherapeutic treatment compared to children with other psychiatric disorders” (Abbas et al., 2017, p. 442).

References

Lyrakos, G., Spinaris, V., & Spyropoulos, I. (2017). The introduction of psychotherapy in

psychiatric outpatients as part of the treatment in the last four years in a Greek

hospital. European Neuropsychopharmacology, 27(4).

Adams, G. C., McWilliams, L. A., Wrath, A. J., Adams, S., & Souza, D. D. (2017).

Relationships between patients’ attachment characteristics and views and use of

psychiatric treatment. Psychiatry Research, 256:194-201.

Abbas, S., Ihle, P., Adler, J., Engel, S., Günster, C., Holtmann, M., & …Schubert, I. (2017).

Predictors of non-drug psychiatric/psychotherapeutic treatment in children and

adolescents with mental or behavioral disorders. European Child & Adolescent

            Psychiatry, 26(4).

Evidence-based discharge teaching is critical in promoting health and impacting readmissions. You will address Tina Jones’ diagnoses; asthma, dehydration, and wound infection, providing education that will support adherence and prevent readmission.  Provide clear guidance for wound care, infection control, medications, diet, blood sugar monitoring, activity, and follow-up that will optimize her health.

Discharge teaching on Tina Jones on the following:

Diabetics

Addresses all areas of the diagnosis, including pathophysiology, risk factors, and health promotion using current EBP in a patient centered manner demonstrating caring behaviors with use of therapeutic communication.

ASTHMA

Addresses all areas of the diagnosis, including pathophysiology, risk factors, and health promotion using current EBP in a patient centered manner demonstrating caring behaviors with use of therapeutic communication.

DEHYDRATION

Addresses all areas of the diagnosis, including pathophysiology, risk factors, and health promotion

nursing current EBP in a patient centered manner demonstrating caring behaviors with use of therapeutic communication

INFECTION

Addresses all areas of the diagnosis, including pathophysiology, risk factors, and health promotion using current EBP in a patientcentered manner demonstrating caring behaviors with use of therapeutic communication.

WOUND CARE

Thorough instruction on asepsis, wound care and equipment using current EBP in a patient-centered manner demonstrating caring behaviors with use of therapeutic communication

MEDICATION

Thorough instruction on medications, including indication, dosing, adverse effects, adherence, and administration using EBP in a patient-centered manner demonstrating caring behaviors with use of therapeutic communication.

ACTIVITY

Thorough instruction on activity, including bathing, equipment, and safety using EBP in a patientcentered manner demonstrating caring behaviors with use of therapeutic communication

DIET

Thorough instruction on proper diet for diabetes management, including counting carbohydrates, hypo- and hyperglycemia, and lifestyle changes using EBP in a patient-centered manner demonstrating caring behaviors with use of therapeutic communication

FOLLOW UP

Thorough instruction on instructions on follow-up plan, including appointments and warning signs of potential problems using EBP in a patient-centered manner demonstrating caring behaviors with use of therapeutic communication.

No errors in APA, Spelling, and Punctuation. Provides two or more references.

3-4 pages