Discuss about the Evaluating the Usefulness of Evidence for Inquiry in Health Care.
Evaluating the Usefulness of Evidence
Stress is widely known as the main ingredient in a majority of today’s illnesses. As a health practitioner, it is important to know the most efficient drug to any sickness. In this case, the evaluation of evidence is necessary. This apparaisal allows one to make a good judgment while recommending it to any patient. This paper appraises two articles, providing a review of the level of evidence as well as the strengths and weaknesses.
Part One: Haaren et al. (2015)
Haaren et al. (2015), carefully introduce the article, stating clearly the purpose of the article. The abstract provides a clear and concise look at the article. The test population, sixty-one inactive students, is briefly described, stating clearly that the exercise was a Randomized Controlled Trial.
The authors go on to define what daily life stress is, basing their argument on the on different scholarly journals. It is in this introduction that one can understand the necessity of the experiment, through the understanding of the effect of perceived daily stressors on physical as well as emotional functioning. The examples given to enhance this argument have a strong scholarly basis since the authors have relevant cases. Further, the authors labor to connect physical exercise and mental health. Despite this, it is clear that texts provided have a clear background and are well referenced from the word go.
The article gives a background of how laboratory-induced stress tasks were once used to conduct similar experiments, and despite positive results, a disadvantage is carefully sourced from a scholarly point of view, stating that this method does not give similar results compared to naturally induced stress tasks. This reference to an earlier method and experiment is very thoughtful as it provides the reader with background knowledge that gave positive results. This is a good foundation of an expectation of enhanced positive results since the AET testing of the students uses natural stress inducers.
The body of literature further illustrates the convenience and efficacy of the AET experiment by comparing old ways of methodology, and by concluding that the few studies that had been conducted were cross-sectional. Judging from this, the authors are confident in their experiment, hailing it as an “inexpensive strategy that is easy to use and effective at preventing the development of mental disorders such as depression” (Haaren & Haertel et. al., 2015).
Also, the scholars were keen to avoid past mistake by the use of the Ambulatory Assessment. This means that various methods were incorporated to study the given population. This provides strength to the exercise since all methods are compatible and one method can easily cover what may have been left out by the previous method. The team used momentary self-reports, ecological momentary assessments, and observational and physiological methods.
The presence of a control group that did not participate in the aerobic exercise provided a reliable comparison for the different effects. This choice strengthens the exercise further since it ensures that both clusters experience similar stressors in the classroom; hence there is a little bias within the control group to bring about the significant error in the results.
The assessment periods were chosen, the beginning of the semester and during the examination period, are key contributors to the success of the environment. Clearly, the authors have carefully thought out the life-cycle of a student’s emotional life in regards to school. This is also observed in the incentive given to the students to attend the experimental group, extra credit, indicating that the authors have clearly studied the cohort under study. This means that the population is properly motivated to contribute and participate in the exercise honestly. This is a key step that further reduces error in the final result.
The methodology of measuring mood is however not very efficient. Relating the degree of the students’ mood, good or bad, to matching numbers indicating intensity on a scale is prone to bias. This bias arises from peer pressure or general lack of surety as to how one feels. This is a weakness that can significantly reduce the efficacy of the results. Despite this, the measurement of aerobic capacity provides an accurate account of the current state. The procedure used to conduct this exercise, assessment of emotional stress pre and post intervention, provides a well-spaced interval for easier and almost accurate intervention.
The intensity of the aerobic exercise is near normal. This means that the intervention modeled was within daily practices. The regularity of the exercises was not too intense, but rather designed to fit into the student’s daily routines.
The exercise received positive results with participants who were involved in the exercises experiencing less stress as compared to those in the control group. The authors considerably reduced bias in the experiment and carefully motivated the students. The conclusion offers a precise dissection of the future of aerobic training as a strategy to fight stressors. There is a systematic review of the results. The researchers present the results in stages, from compliance to the relativity factors that one can easily ignore. This strengthens the results by making them easier to understand since they are well broken down and in different aspects.
This paper provides Level One evidence type. The Randomized Control Trial is systematically reviewed by the researchers. Also, the evidence qualifies as Grade A evidence, indicating that the evidence is Strong Evidence.
Part Two: Kim, Yang, & Schroeppel (2013)
In their article, Kim, Yang, & Schroeppel (2013) find out the effects of Kouk Sun Do (KSD), on mental Health. The article’s abstract provides a clear account of the methodology, leaving out any background information on KSD. However, the three researchers are keen to explain the methodology and procedure of the experiment. This ends abruptly with a short conclusion that provides the results of the experiment: KSD has relaxing effects that reduce anxiety and improve mood and self-efficacy.
The experiment focuses on University Students who have “self-reported” anxiety symptoms. This consideration of thirty students who are already willing to participate and have reached out for help to cope with their anxiety provides the researchers with an already motivated group. This translates positively to the results because this population needs minimal supervision and or incentives to participate in the exercises. This is a strength for the experiment as the cohort under study already has a common interest.
The control group comprised of students who had anxiety symptoms but did not participate in the exercises. It is important to note that this provides the experiment with a loophole, since these students may still have the desire to seek help on their own to cope with their anxiety. Therefore, it is wrong to assume that these students in the control group, who already have self-reported anxiety symptoms, would wait until the period of the experiment is over to seek help. This is one major source of error in the final results. This weakness crops from the control group that is essential in the final evaluation.
The authors’ decision to conduct two tests, one before the intervention and after, is critical for the experiment. An original record will provide an excellent source of control on a personal level since the accuracy of data from the control group may or may not be compromised. Despite this, participants in the treatment group obtain data with minimal error. This is a strength that contributes to one set of accurate data for each after the intervention. The two by two Analysis of Variance table provides a proper comparison of the change of mood and emotion over time in the groups, under the KSD exercises. According to this table, a reader can conclude at a glance, the interrelation between exercises and time.
In the choice of the procedure, ten seventy minutes KSD sessions seem too intense for students, especially those who do not engage in physical exercise. This is one of the major reasons why twelve participants dropped out before the intervention was over. Note that, at first, the students had self-reported anxiety symptoms, implying that a majority had the motivation to join the treatment. However, for forty percent of the willing participants to drop out, this indicates that the exercise was either too much to handle or smooth into while still studying, among other personal reasons. The exercise was not well-designed for the cohort under study. This ten seventy minute sessions can easily be broken down further to reduce the added stress of muscle tension or fatigue the following day. This is a significant weakness in the procedure and methodology preferred. It further illustrates that the researchers did not understand the physical and somatic nature of the students under study. In addition to this, exercise is an activity that goes hand in hand with motivation. The researchers did not motivate the students enough, indicating that for KSD exercises to deem effective, instructors must fully inspire the participants.
The use of open-ended questions to proceed with data evaluation strengthened the accuracy of the conclusions drawn from the experiment. Open-ended questions provide detailed insight into the participants’ experience. Over the entire four week period, the researchers realized a drop in the anxiety symptoms as well as depression. The results were positive, even after comparison with the control group. This means that regardless of any other form of stress coping mechanism that may have been undertaken by anyone in the control group, KSD provides a faster solution to reducing anxiety and depression.
This paper provides level II evidence and moderate evidence.
Part Three: Justification of Strongest Evidence
It is important for Mariana to relax, given her medical history and the stressors in her life. These include minimal family support and her daughter’s asthma. In addition to this, she has diabetes and also has a rare blood disorder.
In the case of Mariana, the first paper by Haaren et al. (2015), is the most relevant in her case. Mariana is concerned about mixing with other students, but the involvement in aerobic exercises provides a standard platform where all participants share a common activity. This means that in this setting, their priorities are more or less the same, and the need to feel different is greatly reduced.
Also, asthma from her child is a stress inducer for Mariana. Luckily, she lives close by the school, and she can walk to and from school. As observed in Haaren et al. (2015), even four minutes walks contribute to aerobic exercise. Adding these walks to her general aerobic exercises will aid in the inducing the relaxing effects of aerobic exercises. Consistency in aerobic training will also aid her in coping with diabetes as well as prevent obesity.
If Mariana was to fully incorporate the outlined aerobic exercises presented by Haaren et al. (2015), she would reduce her stress in the first two weeks and would experience an improvement in her mood. The exercise times are well designed to fit her school and family schedule. In addition to this, the exercises are gentle enough, yet effective, to suit her self-efficacy.
von Haaren, B., Haertel, S., Stumpp, J., Hey, S., & Ebner-Priemer, U. (2015). Reduced emotional stress reactivity to a real-life academic examination stressor in students participating in a 20- week aerobic exercise training: A randomised controlled trial using Ambulatory Assessment. Psychology Of Sport & Exercise, 20, 67-75. Retrieved from https://ezproxy.acu.edu.au/login?url=https://www.sciencedirect.com/science/article/pii/S1469 029215000357
Kim, J., Yang, H., & Schroeppel, S. (2013). A Pilot Study Examining the Effects of Kouk Sun Do on University Students with Anxiety Symptoms. Stress & Health: Journal Of The International Society For The Investigation Of Stress, 29(2), 99-107. Retrieved from https://ezproxy.acu.edu.au/login?url=https://dx.doi.org/10.1002/smi.2431