Cognitive-Behavioural Group Intervention For Climacteric Syndrome

The Importance of Nursing Research and Evidence-Based Practice

Describe about the Cognitive-Behavioural Group Intervention for Climacteric Syndrome?

Nursing research is said to have remarkable control on existing and upcoming proficient nursing practice, consequently, making it indispensable element of educational process. Nursing research is considered as critical factor to nursing occupation and also considered as essential component for maintaining developments that sustain most favorable nursing care (Polit & Beck, 2004). Nurses utilize research to offer evidence based care which promotes eminence health related outcomes for the families; individuals; healthcare setups and communities. Nurses also utilize research to structure health guidelines in care in an organization and at federal, state and local levels. Nurses carry out research; apply research studies in practice and educate about research. 

Strong nursing skill is must to construct clinical proficiency. Knowledge to build up well-structured scientific judgments is completely depending upon experimental learning, where individual nurse can examine, disconfirm and improve the expectations. Development is necessary for setting up credibility, essential within the clinical management provision.  Researchers have illustrated relationship with improved practice in nursing with the experiences of the nursing professionals. To make nursing professionals efficient in initiating and negotiating changes, they need to be positioned in managerial situations, which give them authority and control to have a good effect on development. The base of superior nursing practice and strength associated with nursing accountability lies in experimental expertise.

According to Ellis (2010), nursing professionals are eager to execute efficient nursing researches for the care of their patients (Ellis & Hartley, 2012).  Evidence based practice in nursing includes different types of evidences, for example: reviews, research findings, incorporation and theories of the evidences for the betterment of patients’ health. Currently, this concept has been set to modify and improve the primary and self-motivating power within the nursing professionals. It is frequently observed that inexperienced professionals are unable to understand the importance of utilization of research as the source of making decisions and flourishing nursing interferences (Twycross, 2011). Hence, the idea of research and discussion are still improving to overcome the barriers associated with evidence based practice implementation within health care set up. 

A fundamental goal in the health care set up is to deliver an effective and safe healthcare. To meet up this fundamental goal, midwifery practitioners and nurse should achieve and maintain an interest and awareness in nursing research (Proctor & Hargate, 2013). This process can be discouraging given the complexities and continual change brought about by the social and healthcare challenges. These changes comprise age associated health concerns in children and adults, for example lifestyle associated persistent diseases, such as: heart disease, diabetes and so on. Evidence based midwifery or EBM has its origin rooted in evidence based medicine development, which has gradually grown from physician’s concerns regarding growing number of clinical trials, but without any attempt to implement the findings to the medical practice (Bick, 2011). Hence, evidence based practice illustrates the significance of implementation of the finest obtainable facts in practice. Nursing and midwifery is considered as a diverse discipline in epistemological sense. This means philosophical analysis of human acquaintance in the content of its nature, origins and limits. Research in this area encompasses wide range of methodological and philosophical searches. 

Stress Management for Women During Menopause

Title 

The chosen topic of interest is the efficacy of stress management program to improve the ability of perimenopausal women to deal with stress. If the area of nursing practice for the writer is midwifery then selecting this topic is very much significant. This is because the condition ‘perimenopause’ is firmly associated with women’s health and midwifery practice is very much focused on women’s health. Perimenopause can initiate almost 8-10years prior menopause. During this time the ovaries slowly generate less amount of estrogen. This stage is generally commenced during 40s, but currently researches have stated that because of lifestyle women are attaining perimenopause during their 30s as well (Kia, Golzari & Sohrabi, 2013). Perimenopause stays until menopause. It is a key factor to properly select a research title. A strong, meaningful and precise title generally attracts the readers. An article may be structured efficiently with loads of information and relevant facts, but lacks a good title. In that case readers might feel less interested to go through the write up. This is because readers prefer choosing materials based on the title and abstract. Therefore, while constructing a paper the researcher should be careful enough about the selection of an appropriate title for the research. In this research study Iioka and Komatsu (2014) have selected a very efficient title for their research study, which has justifiably mentioned about the overall concept of their research study.

Abstract 

A proper abstract should precisely state the aim, methods, results and conclusion. This article has also included precise aim, methods, results and conclusion. The aim of their research was to examine the efficacy of a stress management program on perimenopausal women to increase their capacity to deal with their stress. They have considered quasi-experimental design and provided the subject participants with a stress management program. They have divided the group into two sections, one control group and the other one experimental group. This program included group discussion, hands on training and short lectures for three weeks (Iioka & Komatsu, 2014). They have set primary and secondary outcome along with hypothesis. In result part they have compared between primary and secondary outcome. They have analyzed the participants’ response with the help of statistical analysis. They have concluded that according to their results stress management plan has the ability to improve perimenopausal women’s capacity to deal with their stress and develop their mental well-being. As it is mentioned prior that readers prefer choosing materials based on title and abstract; the researchers need to be careful enough to structure the abstract for their experiment in a very particular way (Nieswiadomy, 2012). Therefore, it can be stated that the authors have justifiably stated the aim, methods, results and conclusion in the abstract region, which is compact enough for the readers to understand about the entire research study. 

In the introductory part the researchers have mentioned about basic reason behind menopausal stress in Japan. They have stated that the phase is very decisive and a state of great emotional and physical alteration takes place in each and every woman’s life. Therefore, during this transitional phase controlling own health and planning for an effective coping technique is very significant for this group. So, in this part the authors have elaborated about the incidences that commonly take place during this stage. Next they have mentioned about affecting psychological factors and indications. This will aware the target population about the associated indications faced by them. They have especially mentioned that this research concentrated not on the stress phenomenon reduction but on the competence to deal with different life stress, for what a proper stress management program is very much necessary. By this statement they have clarified their research focus. They have also suggested that incorporated approach depend on various factors is more effective than concentrating upon single symptom (Chan, 2010). Thus they have justified the reason behind choosing various factors associated with stress, in their research study. An introduction of a research should include the background of the research, relevant statistics on the chosen topic and ultimately should lead the readers from particular common subject area to special research field. Introduction establishes the significance and context of a research study by précising present understanding and background data of the chosen topic. Thus, this introductory section has nicely stated aim of the work as research problem and support by hypothesis. This section has also briefly illustrated the practical approach applied in this research study to analyze the research problem and highlighted the probable consequences of this study and outlined the rest of the structure of this study (Hsu, Kuo, Chang, Wu & Huang, 2011). So, why it is justified to mention that this introductory part of this research study is good because the structure answers about few basic questions: what is the reader studying? Why the selected topic is important to examine? How the readers are informed prior they have gone through this study and how this research will advance knowledge and latest mode of understanding.

Critique of a Research Article

In this research study the researchers have not separated any particular section on literature review but in the introductory part they have added some point of views from the prior available research studies. In the introductory part they have mentioned that the researchers from Japan Academy of Nursing Science have stated that if stress management was applied flexibly to go well with the circumstances, then the reaction of stress was diminished, depression and anxiety were healed and mental and physical well-being was improved (Dougherty, 2009). Therefore, Iioka and Komatsu focused on women’s capacity to deal with stress and not on the stress phenomenon reduction strategies. In few parts they have supported their comments with prior review papers on relevant topic. Literature review gives a practical direct to a specific topic. If the time is restricted for the research, literature review offers an overview (Jomeen, 2004). It gives a firm background for the investigation of research papers. Comprehensive knowledge is very much essential prior conducting a research study. This paper demonstrated no as such reviews of literature. 

Good research design minimizes the probable alternative details for hypothesized association between cause and effect. Prior selecting an efficient research design researchers should consider time, treatments or programs, observations and groups. In this study researchers included quasi-experimental design with nonrandom allocation of participants. In this research study choosing quasi-experimental design is very much significant (Cutcliffe & Ward, 2007). This can be easily illustrated by comparing randomized controlled trial with quasi-experimental design. In case of randomized controlled trial the researchers assign participants in a randomized way without knowing any particular data of the participants, hence completely randomized. In case of the quasi-experimental design, researchers are well aware of any particular factor of the study participants, hence the participant allocation is considered as nonrandomized. In this research selecting this approach was good. This is because the focus of the study was perimenopausal women.

They have assigned two programs for two individual participant groups. For experimental group they have assigned new combined stress management program and for the controlled group they have assigned self-guided learning program. The researchers have clearly mentioned about the inclusion and exclusion criteria of their research articles. Inclusion criteria were more indications of menopause associated stress response; participants were within the age of 40-59years and experienced early, late or surgical menopause (Ganz, 2000). Excluding criteria were: score of 16 or more on HADS; treatment alterations for menopausal indications in past 3months; history of persistent illness or cancer and analysis of psychological illness. Thus, it can be stated that the researchers have specifically illustrated the characteristics of the prospective subjects, which were to include in their research study. The researchers have clearly stated their set hypotheses that clarify their research direction (Lepore, Fernandez-Berrocal, Ragan & Ramos, 2004). The primary hypothesis set by them was that: experimental group which takes part in stress management program will exhibit improved capacity over control group to manage with stress. Secondary hypothesis included that: experimental group will have more mental well-being than control group; experimental group will experience more relief from stress associated symptoms. Therefore, from the hypotheses they have made it clear that their research was concentrated on stress and not on reducing and relieving stress.

The researchers have recruited study participants through public relation activities, using leaflets, posters. To improve the commitment and motivation, participants were allowed to select program according to their wish. To carry out a good and efficient statistical analysis, the researchers have set proper measurements that were linked with primary outcomes, means the capacity to deal with stress, includes knowledge test, coping flexibility scale, lecture session, group discussion, manageability scale and secondary outcomes were focused on perception of physical condition scale, anxiety and depression scale, menopausal symptom assessment chart (Narasimhan & Jordache, 2000). They have collected data based on: outcome data, baseline prior intervention, and outcome data after intervention and follow up data after a month. Based on this it can be said that they have taken a clear-cut approach in order to successfully carry out the statistical part of their research study. This will definitely help the readers to go through the variations and differences between two allotted programs, between two participant groups.

The researchers have perfectly divided this section into subject characteristics, hypotheses outcome (primary and secondary). They have reported statistically significant result, where they have hypothesized that experimental group which takes part in stress management program will exhibit improved capacity over control group to manage with stress. Statistically if the p-value is more than 0.05, then the null hypothesis is accepted (Hayat, 2010). Here this above mentioned hypothesis was considered as H0 or null hypothesis and hence this above mentioned fact was accepted. This proved the effectiveness of stress management program among the perimenopausal women.  Another hypothesis stated that experimental group will have more mental well-being than control group; experimental group will experience more relief from stress associated symptoms (null hypothesis). After performing the statistical analysis, it was seen that p-value is more than 0.05; hence the null hypothesis was accepted. Thus, as a whole the researchers have stated from the statistical analysis that stress management plan has the ability to improve perimenopausal women’s capacity to deal with their stress and develop their mental well-being.

According to researchers stress management program has been addressed properly and could be suggested with different settings. This program is expected to be efficient along with medication management, associated with menopausal disorders and ultimately effective for those who do not prefer medications and women with minor symptoms (Cheng, 2009). The limitation of this research study includes non-comparable control structure, poor external validity and self-selection. Therefore, further research studies are expected on same topic, which should include randomized controlled trial, bigger sample size to confirm program efficiency (Taddei et al., 2009). To carry out this research, the researchers have taken permission from the international council, which showed that the researchers are well aware of the importance of taken approval prior conducting the research study. An idea of generalization should be adopted. The consequences from one set of investigational conditions can be generalized to similar series of conditions. As in this research study when the readers, especially the women group (perimanopausal) will go through this research study will definitely try to compare with their personal experiences (Alder et al., 2006). Not only that, physicians may also compare their ongoing medial data of their patients, in order to understand the condition and come to a diagnosis or a treatment plan. This research has given a further opportunity to illustrate on the same topic and meet the current research gap.

References:

Alder, J., Eymann Besken, K., Armbruster, U., Decio, R., Gairing, A., Kang, A., & Bitzer, J. (2006). Cognitive-Behavioural Group Intervention for Climacteric Syndrome. Psychother Psychosom,75(5), 298-303. doi:10.1159/000093951

Bick, D. (2011). Evidence based midwifery practice: Take care to ‘mind the gap’. Midwifery, 27(5), 569-570. doi:10.1016/j.midw.2011.08.002

Chan, Z. (2010). Clinical research issues in nursing. New York: Nova Science Books.

Cheng, C. (2009). Dialectical Thinking and Coping Flexibility: A Multimethod Approach. Journal Of Personality, 77(2), 471-494. doi:10.1111/j.1467-6494.2008.00555.x

Cutcliffe, J., & Ward, M. (2007). Critiquing nursing research. London: Quay Books.

Dougherty, M. (2009). Peer Review and the Nursing Literature. Nursing Research, 58(2), 73. doi:10.1097/nnr.0b013e31819f1589

Ellis, J., & Hartley, C. (2012). Nursing in today's world. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Ganz, P. (2000). Managing Menopausal Symptoms in Breast Cancer Survivors: Results of a Randomized Controlled Trial. Journal Of The National Cancer Institute, 92(13), 1054-1064. doi:10.1093/jnci/92.13.1054

Hayat, M. (2010). Understanding Statistical Significance. Nursing Research, 59(3), 219-223. doi:10.1097/nnr.0b013e3181dbb2cc

Hsu, C., Kuo, H., Chang, S., Wu, T., & Huang, K. (2011). The assessment of efficacy of Diascorea alata for menopausal symptom treatment in Taiwanese women. Climacteric, 14(1), 132-139. doi:10.3109/13697137.2010.498594

Iioka, Y., & Komatsu, H. (2014). Effectiveness of a stress management program to enhance perimenopausal women's ability to cope with stress. Japan Journal Of Nursing Science, 12(1), 1-17. doi:10.1111/jjns.12036

Jomeen, J. (2004). The importance of assessing psychological status during pregnancy, childbirth and the postnatal period as a multidimensional construct: A literature review. Clinical Effectiveness In Nursing, 8(3-4), 143-155. doi:10.1016/j.cein.2005.02.001

Kia, M., Golzari, M., & Sohrabi, F. (2013). The Effectiveness of Teaching Stress-coping Strategies to Enhance Marital Satisfaction of Women After Partners’ Extramarital Affairs. Procedia - Social And Behavioral Sciences, 84, 70-75. doi:10.1016/j.sbspro.2013.06.512

Lepore, S., Fernandez-Berrocal, P., Ragan, J., & Ramos, N. (2004). It's not that bad: Social challenges to emotional disclosure enhance adjustment to stress. Anxiety, Stress & Coping, 17(4), 341-361. doi:10.1080/10615800412331318625

Narasimhan, S., & Jordache, C. (2000). Data reconciliation & gross error detection. Houston: Gulf Pub. Co.

Nieswiadomy, R. (2012). Foundations of nursing research. Boston: Pearson.

Polit, D., & Beck, C. (2004). Nursing research. Philadelphia: Lippincott Williams & Wilkins.

Proctor, G., & Hargate, R. (2013). Quantitative and qualitative analysis of a set of goal attainment forms in primary care mental health services. Counselling And Psychotherapy Research, 13(3), 235-241. doi:10.1080/14733145.2012.742918

Taddei, A., Van Houwe, G., Nagai, S., Erb, I., van Nimwegen, E., & Gasser, S. (2009). The functional importance of telomere clustering: Global changes in gene expression result from SIR factor dispersion. Genome Research, 19(4), 611-625. doi:10.1101/gr.083881.108

Twycross, A. (2011). Using research findings in nursing practice. Evidence-Based Nursing, 14(3), 63-63. doi:10.1136/ebn1170