A Critique Of Research Evidence Into The Prevention And Self-management Of Diabetes In The UK (Term Paper Sample)

A CRITIQUE OF RESEARCH EVIDENCE INTO THE PREVENTION AND SELF-MANAGEMENT OF DIABETES IN THE UK
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Introduction
An Evidence-based practice (EBP) is an integral part of basic nursing intervention as it emphasizes on basic nursing interventions ( Leaufer and Cleary-Holforth 2009). EBP enhances the quality of healthcare, patient outcome, and reliability while also lowering variation on care and costs (Mosli 2014). The effective provision of EBP calls for the research paper identification and critique (Dale 2012). Therefore, the research paper assesses the strength and quality of evidence offered in two primary research studies to find out if the work could be effectively applied in practice. The two primary research papers chosen for analysis addresses the burden of diabetes on the UK health system (Francis 2012). The focus of the study paper is the improvement of the diabetes prevention within the quantitative study and self-management using the qualitative study of diabetes in the United Kingdom.
The topic is interesting due to the magnitude of the health system burden that chronic diseases cause. Currently, it accounts for approximately 10% of the US health service budget (Piwek 2016). Both research papers focus on education of diabetes patients, therefore, upholding a problem solving strategy for medical care. Notably, individualized approaches to prevention and self-management are fundamental avenues of practice that researchers should address and advance (Cooke, Bond, Lawton and Rankin 2012. The paper also provides a brief overview of EBP and relation to Nursing Practice as well as the way research critique act as an essential skill.
Appraisal of Two Research Papers
Discussion of Methods and Methodologies
The methodologies of the Holland and Ree's article focused on diabetes harm-minimization strategy in the management of self-risks (Holland and Rees 2010). It heavily depends on grey literature and the opinion of experts as its base of evidence. Even though expert opinion is viewed as poor quality in the evidence hierarchy, there are instances when it offers the best available confirmation in practice (Uhlig 2014). In the context of enhancing expert patient involvement in healthcare and research, the ability to critique expert opinion is significant (Guess, Caengprasath, Dornhorst and Frost 2015). Therefore, analysis of the present frameworks and assessment of a considerable number of articles that should be covered when publishing expert opinion is needful (Uhlig 2014). The inclusion of expert opinion within the project was vital in giving answers to the proposed questions. Professional communication showed advantages of expert opinions within harm-minimization suggestions (Ehde 2014). The element influences practice and brings about rising emphasis on the service-user participation within the service provision (Hunt, McGee, Gutteridge and Hughes 2012). The term expert-by experience stresses the relevance of service users and the practitioners working together (Ehde 2014). Besides, the significance of EBP in comparison to (Evidence-Based Medicine (EBM) is creating room for inclusion of evidence even if it is not rated as highest standard according to the hierarchy of evidence (Wingham 2014).
The Second paper utilizes the Critical Appraisal Skill Program (CASP) tool for the critique of the chosen qualitative investigation. The purpose of the qualitative study by Rankin, Heller, and Lawton (2011) is the improvement of the delivery of individualized education of practice with Type 1 diabetes. The research identifies five significant reasons for knowledge shortfalls in patients in the Dose Adjustment for Normal Eating (DAFNE) programme to assist in self-management of the diseases (Whiffin and Hasselder 2013). The platform includes an established education intervention for clients with Type 1 diabetes using inductive, thematic analysis of 30 patients that suffer from chronic diseases (Bott, Bott, Berger and Mьhlhauser 1997).
The qualitative research study undertakes semi-structured interviews of 30 Type 1 Diabetic patients in the UK with age, sex and occupation diversity (Wingham 2014). All participants had enrollment in a DAFNE course, but the duration of their admission in the course was unclear (Whiffin and Hasselder 2013). The study realized that diagnosis of diabetes in adolescence or infancy and parental involvement is harmful to the knowledge of patients and self-management of the disease the upcoming stages of life. The research also found out that patients engaging in current responsibilities and new roles impacted self-management ability. For that reason, the study could be helpful in EBP to determine significant stages in the lives of patients when it is vital to support them with diabetes' self-management (Whiffin and Hasselder 2013).
Brief Search Strategy
The paper utilize Holland and Ree's framework as a search strategy and critique of the quantitative research article in ‘Nursing Evidence-Based Practice Skills' (2010). The chosen quantitative study is Guess, Caengprasath, Dornhorst and Frost (2015). The relevance is that it uses 59 subjects and assess if persons at high danger of Type 2 diabetes enrolled through general practices (GP) was educated about their risk standing by a health expert. It also examines the impact of the information on their lifestyle and if the perceived risk is connected to dietary intake (Guess, et.al. 2015). The finding of the research was that more than half of the contributors recognized as high risk did not get data of their risk standing from experts (Guess, et.al. 2015). Besides, a third of the participants did not understand the responsibility of diet, exercise, and weight management in risk reduction approach by NICE (Rijken 2014).
Link to Evidence Hierarchy
The evidence hierarchies development was significant to assist professionals when classifying and evaluating evidence with an increased level of effectiveness and validity (Parsons 2014). The randomized control trial (RTI) is in most cases the gold standard of evidence and that places it at the highest part of the hierarchy (Jansen, Van Oers, Kok and De Vries 2014). The reason is that it is a form of research which offers the most accurate outcomes (Parsons 2014). Majorly, the methodology lowers the risk of factors that affect the results (Lindsay 2014). On the other hand, systematic reviews have brought about debates in regards to the top sport (Gutnick 2014). The nature of the study called for the exploration literature and demanded other forms of research such as qualitative methodologies (Parsons 2014).
Critiquing Framework Choice and Rationale
The framework that was used in the assignment is two critique model which include the CASP approach and Holland and Rees' framework as a qualitative and quantitative research method (Holland and Rees 2015). The rationale is that they assisted in the analysis of a quantitative and quantitative research method to relate to the self-management and diabetes prevention in the UK (Hoole and Morgan 2011).
The strength of the CASP Article
The data collection was through a start-up telephone screening and participants were offered the Risk Perception Survey for Developing Diabetes (RPS-DD). The article is vital because it identifies the extensive flaw in diabetes management in GP practices without bias (Holland and Rees 2015). Another strength is the stage screening process because it presents an accurate risk assessment and deciphers between perceived and actual risk (Burke 2014). Furthermore, stage screening process assists in the calculation and categorization of risks into low, moderate and high levels as at a low cost.
Analysis of the Strength of CASP Article
Telephone screening in the CASP article reduced response because the interviewer could not physically influence answers (Wingham, J.2014). Besides, the anonymity of telephone screening reduced the bias of an interviewer and set up the interview to be forthcoming and calming. The aspect brought about accurate and truthful data collection. The brief questions from telephone interview prevented contamination of answers and loss of the interviewers’ control (Devereux-Fitzgerald and French 2016). Besides, the research was less expensive and the most efficient in reducing the required time for data collection.
The weakness of the CASP Article
The claim of the research is that there was a slight adaptation of RPS-DD for the UK population (Eldredge 2016). However, the study does not state the way it was adapted and the reason it could interfere with the survey validity. It is evident that the method of quantitative research is effective, but 59 subjects sample size is too small for the research to be reliable, therefore, affecting its generality (Carey 2014). The next weakness is that the participants were approached by use of telephone screening which has effects on availability, therefore, it may not lead to a diverse sample of the UK population.
Analysis of the Weakness of CASP Article
The research used telephone screening and that denied it the opportunity to handle a complex question that required a social response. Furthermore, the study had reduced reliability and validity because the respondents had limited comprehend the questions and provide a well-thought answer (Paterson 2015). Furthermore, the research method was not intrusive and the interviewers had no chance to study gestures and facial expressions to determine the truthfulness of a response. The survey had brief questions, therefore, denying the respondents the opportunity to be informative by elaborating on their answers.
The Strength of Holland and Rees’ EBP Approach
The EBP strategy emphasizes the significance of service user views as well as e...