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HLSC122 Critical Appraisal Scenarios

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1. What are the esperiences of men with PTSD taking Yoga to improve Wellbeing?
 
2. How Effective are e-cigarettes compared to other nicotine replacement therapies for smoking cessation in Adults?
 
 

Answer:

Introduction

Post-traumatic stress disorder (PTSD) is a health issue that is caused by exposure to traumatic events. The individuals diagnosed with PTSD suffer from physiological and psychological distress (Javidi & Yadollahie, 2012, p. 3). Controversies exist on which is the best treatment method between exposure therapies and the use of complementary methods to address PTSD symptoms. The objective of this critique paper is to appraise the qualitative descriptive study by Jindani and Khalsa (2015) to ascertain the presence of any high-quality evidence that affirms the use of yoga treatment as a complementary approach to treating adults with PTSD symptoms. The evidence is to be used as a basis for convincing Tessor to undertake yoga treatment to alleviate him of PTSD symptoms.

The authors of the article are Farah Jindani and Khalsa with Ph.D. and BA qualifications respectively. A doctorate qualification in healthcare is an acknowledgment of being an expert or consultant in the field of health. This implies that the study findings are professional and inferences made can be relied upon.

Additionally, Jindani who is a Ph.D. holder can influence healthcare policy and procedure. This makes the findings and recommendations more reliable to different stakeholders of interest. JIndani is also affiliated to the Centre of Addiction and Mental Health, Canada; an exposure which enables the author to be updated with the current issues related to mental health even though he doesn’t have professional certification qualification which is essential in the provision of healthcare services.  Khaisa is a BA holder affiliated to the University of Toronto Multi-Faith Centre for Spiritual Study and practice, Canada. Bachelor’s qualification is not regarded as an expert in any field, and this limits her knowledge about the topic under investigation. However, the affiliation with the University of Toronto provides him with the necessary expertise needful for the research.

Since both authors are addressing a research that is relevant to their institutions of affiliation, they may be reluctant or biased in their approach especially if an issue affects the institutions.

Research Aim

Post-traumatic stress disorder (PTSD) is attributed to psychological and physiological distress. An effective treatment for this disorder has however not been adequately addressed. Studies have shown that exposure therapies usually used for the treatment of PTSD worsen the situation resulting in trauma-related body sensations and an awakening of implicit memories (Cloitre et al., 2010, p. 915). A study by Rauch et al. (2009) found out that exposure therapies reduce the symptoms of PTSD but do not improve the overall health, social, and job-related functioning of the patient.  This has necessitated the need for complementary treatments that focus on both body and mind. Studies have demonstrated yoga as the best complimentary treatment in primary health care as it deals with both body and mind (Köhn, Persson Lundholm, Bryngelsson, Anderzén-Carlsson, & Westerdahl, 2013; Van der Kolk et al., 2014). However, no study has examined the experiences of yoga treatment for PTSD patients, and hence this study aims at exploring the experiences of individuals with PTSD symptoms who are undergoing yoga treatment.

The study adopted a qualitative descriptive study. This is an observational study which describes the occurrence of disease patterns in association with variables such as persons, time and location. A qualitative descriptive approach involves the observation of subjects in a natural and unchanged environment.  Neergaard, Olesen, Andersen, and Sondergaard (2009, p.2) observes that the method is most appropriate when ascertaining the where who and what of a phenomenon and when obtaining information from subjects about an aspect that is not adequately understood. This, therefore, makes a qualitative descriptive approach the most appropriate for the study which is aimed at examining the actual experiences of subjects with PTSD symptoms to ascertain whether yoga treatment is the most appropriate complementary treatment of PTSD symptoms.

Research Methods

The authors used posters, online bulletin, and advertisements to recruit prospective participants. Posters are significant because they can reach a large group of people within a short time. However, their effectiveness is dependent on the initial encounter with the people, which also determines their response.  An online bulletin is most appropriate in reaching a wide population range, but it is limited to those who have internet access only (Bartneck, Duenser, Moltchanova, & Zawieska, 2015, p.10).

Data collection methods included audio-recorded telephone and semi-structured interviews. Audio recordings enhanced data immersion and the closeness of the authors with the data alongside increasing transcription accuracy due to the aspect of reading and re-reading. Telephone interviews enable simultaneous data collection and provide actual information from the respondent. However, the reliability of the data gathered is affected and depends on the mood status of both the interviewer and interviewee (Novick, 2008, p. 395).

Data analysis was done using qualitative thematic analysis and Inductive thematic analysis. The qualitative thematic analysis enabled the researcher to obtain more information about the topic with which little is known. The use of inductive thematic analysis provided the authors with an insight into the opinions or experiences of the respondents of the yoga program (Braun & Clarke, 2014, p. 1).

 

Results and Study Limitations

Yoga treatment programme produced changes in aspects of health, lifestyle, welfare, views of self-regarding the world, and psychosocial integration. Yoga treatment is an alternative approach to the treatment of trauma and addresses the primary components of PTSD such as mind and body.

The eight-week classes of the yoga programme required individual motivation of the participants to ensure its success. The lack of the personal motivation discouraged others from completing the exercise upon which the findings were dependent on.

The findings from the study by Jindani and Khalsa (2015) are authentic and reliable for various reasons, and hence I would apply them to the clinical practice in the scenario of Tasso. The study findings are based on the real experiences of 40 adult men with PTSD symptoms. This validates the practicality of the inferences made from the study on the effectiveness of yoga treatment in the case of Tasso. Additionally, the authors have used standardized methods and instruments for data collection and analysis. This reduces any possibility of bias which can be caused by the manipulation of analysis outcomes by the researchers (Pannucci & Wilkins, 2010, p. 2). Transcription accuracy was increased through reading and re-reading of the recordings, which further increases the credibility of the findings. The study found out that yoga treatment is an appropriate self-care tool that is significant in alleviation from PTSD symptoms, and the skills can be learned by individuals and individually implemented at home when one is under stress. Moreover, the authors found out that yoga treatment improves ones social, job-related functioning, and social aspects besides reducing PTSD symptoms (Jindani & Khalsa, 2015, p. 406). These findings justify the application of the information from the study in the given scenario and to the clinical question.

Conclusions

The debate on the most appropriate approach in the treatment of PTSD symptoms has led to the increase in the studies focused on examining the best procedure between complementary and exposure treatment. Studies show that exposure treatment is crucial because it reduces PTSD symptoms, however, it is contraindicated for survivors who end up having experiences associated with trauma. Other studies have also demonstrated that body-mind interventions are best suited for individuals with disorders related to stress and mental illness. Furthermore, this study evidently shows that yoga is an approach treatment that is a self-care tool that is comprehensive and is most appropriate in addressing PTSD symptoms because it leads to an improvement in the health, social, and job-related functioning besides reducing PTSD symptoms. This, therefore, makes yoga treatment the best approach in the case of Tassor.

 

References

Rauch, S. A., Grunfeld, T. E., Yadin, E., Cahill, S. P., Hembree, E., & Foa, E. B. (2009). Changes in reported physical health symptoms and social function with prolonged exposure therapy for chronic posttraumatic stress disorder. Depression and anxiety, 26(8), 732-738. Retrieved from https://deepblue.lib.umich.edu/bitstream/handle/2027.42/63596/20518_ftp.pdf?sequence=1&isAllowed=y 

Braun, V., & Clarke, V. (2014). What can “thematic analysis” offer health and wellbeing  researchers?. International journal of qualitative studies on health and well-being, 9. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4201665/ 

Cloitre, M., Stovall-McClough, K. C., Nooner, K., Zorbas, P., Cherry, S., Jackson, C. L., ... & Petkova, E. (2010). Treatment for PTSD related to childhood abuse: A randomized controlled trial. American journal of psychiatry, 167(8), 915-924. Retrieved from https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.2010.09081247 

Pannucci, C. J., & Wilkins, E. G. (2010). Identifying and avoiding bias in research. Plastic andreconstructive surgery, 126(2), 619. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2917255/ 

Javidi, H., & Yadollahie, M. (2012). Post-traumatic stress disorder. The international journal of occupational and environmental medicine, 3(1 January). Retrieved from https://theijoem.com/ijoem/index.php/ijoem/article/download/127/233 

Jindani, F. A., & Khalsa, G. F. S. (2015). A yoga intervention program for patients suffering from symptoms of posttraumatic stress disorder: A qualitative descriptive study. The Journal of Alternative and Complementary Medicine, 21(7), 401-408.

Köhn, M., Persson Lundholm, U., Bryngelsson, I. L., Anderzén-Carlsson, A., & Westerdahl, (2013). Medical yoga for patients with stress-related symptoms and diagnoses in primary health care: a randomized controlled trial. Evidence-Based Complementary and Alternative Medicine, 2013. Retrieved from https://downloads.hindawi.com/journals/ecam/2013/215348.pdf

Bartneck, C., Duenser, A., Moltchanova, E., & Zawieska, K. (2015). Comparing the similarity of responses received from studies in Amazon’s Mechanical Turk to studies conducted online and with direct recruitment. PloS one, 10(4), e0121595. Retrieved from https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0121595 

Neergaard, M. A., Olesen, F., Andersen, R. S., & Sondergaard, J. (2009). Qualitative description–the poor cousin of health research?. BMC medical research methodology, 9(1), 52. Retrieved from https://bmcmedresmethodol.biomedcentral.com/articles/10.1186/1471-2288-9-52 

Novick, G. (2008). Is there a bias against telephone interviews in qualitative research?. Research in nursing & health, 31(4), 391-398. Retrieved from https://onlinelibrary.wiley.com/doi/pdf/10.1002/nur.20259 

Van der Kolk, B. A., Stone, L., West, J., Rhodes, A., Emerson, D., Suvak, M., & Spinazzola, Yoga as an adjunctive treatment for posttraumatic stress disorder: a randomized controlled trial. J Clin Psychiatry, 75(6), e559-65. Retrieved from https://accurateclinic.com/wp-content/uploads/2016/04/Yoga-as-an-Adjunctive-Treatment-for-Posttraumatic-Stress-Disorder-A-Randomized-Controlled-Trial-2014.pdf

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