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You are required to demonstrate your ability to critically appraise a piece of literature or evidence (i.e. original research study) provided to you, in relation to a health scenario. Using the Journal Club critical appraisal questions, you will be required to answer these questions in the form of an academic essay.

Scenario: Mindfulness and Stress Reduction  

Steve is a millennial student (born 2000) who has unique views on how a millennial student should be taught, and how they should learn at university. He also believes that mindfulness can reduce stress and should be promoted in a learning environment,  as a strategy to promote the health and wellbeing of university students.  One of his peers, Debbie,  thinks mindfulness is a millennial thing that has little value in promoting wellbeing or reducing stress. Both Steve and Debbie want to find out if practising mindfulness does actually help with reducing stress.

Does practising mindfulness help in reducing  stress among university students?

Background

There is lack of information on how mindfulness intervention can be useful for reducing stress in university students. The aim of this paper is to conduct a critical review of the paper by McConville et al. (2019) which explores the views of a physiotherapy student regarding participation in a mindful stress reduction (MSR) intervention. The paper will evaluate the authorship, research question, research design and key findings obtained to find out the strengths and weakness of the article in addressing the research gap. The report aims to apply the findings in case scenario of Steve. Steve is a millennial student who wants to prove to this friend, Debbie that mindfulness is useful in promoting well-being and reducing stress of university student. The paper will report about barriers and enablers to the application of the study in case of the article.

Authorship

The review of authorship detail is important in a research paper as it gives idea about the affiliation and area of expertise of individual authors. Such details help to evaluate the contribution of the authors in promoting credibility and quality of the research work (Shukla & Supe, 2017). The article by McConville et al. (2019) has been written by four authors. The first author Janet McConville is a senior lecturer in the Discipline of Physiotherapy at the Latrobe University, Australia. Deborah Lewis is an expert in the counseling field. Richard Chambers is the psychology expert of Monash University, Victoria, Australia, whereas Craig Hassed is a professor in the Department of General Practice in the same University. The qualification and affiliation of the authors clearly show how strength of authorship in contributing to the strength and reliability of the paper. The expertise of each of them ensures that the mindfulness intervention has been rightly executed in the study.

Research question & Justification

The study by McConville et al. (2019) investigated about the lived experience of physiotherapy students regarding participation in a MSR intervention. The main rationale for research in this area as stated by the author included lack of research on mindfulness based intervention for physiotherapy students. In addition, the need for research in the above area was stated by discussion on high prevalence of psychological distress in University students. Through review of several research papers, the authors discussed about the prevalence of stress and poor mental health in university students. The author cited several research papers to explain the benefits of mindfulness in reducing psychological distress. The evidence by Janssen et al. (2018) revealed the role of mindfulness in decreasing stress improving concentration, promoting physical resilience and reducing anxiety and depression in patients. Thus, the justification given for the research is appropriate and clearly reflects the study objective.

Authorship

Research design

The authors stated use of qualitative research design to explore experience of physiotherapy students regarding MSR intervention. The selection of the above method is appropriate when any research aims to explore view or opinions related to a social phenomenon. This research design facilitates getting rich and in-depth details about a research topic as it seeks to explain how and why of a particular phenomenon (Garner & Scott, 2013).  The phenomenon of interest in the study included experience of stress and participant’s opinion related to live experience of taking part in MSR intervention was explored. Grossoehme (2014) argues that qualitative research methods are strong tools in exploring the meanings of social phenomena as experienced by an individual in a natural context. Hence, the choice of research design is appropriate to achieve the study aim. One limitation is that the author did not discuss about the rationale for selecting qualitative study design.

Research methods

The strength of sample recruitment is the use of random method to allocate participants into either MSR group or mindful movement. The advantage of simple random sampling method is that it promotes generalization of the results and applying it back to the target population of interest (Sharma, 2017). The participants were recruited only when they agreed to take part in the intervention and this ensured that ethical requirement of informed consent was fulfilled. The data collection was done using interview method after the completion of the programme and the average duration of interview was 46 minutes. The use of interview method is appropriate for qualitative research design (King, Horrocks & Brooks, 2018). The main questions covered in the interview were related to perceived benefits of MSR and factors hindering practice or individual follow-up. But one of the major limitations of data collection method is that the interview was conducted by a student enrolled in psychology programme. This should have been done by any psychological expert instead of a student to enhance the quality of interview.

Results and Limitations

The results of the study revealed the benefits of both six-week MSR intervention and mindful movement intervention. Participants reported improvement in well-being, communication and academic engagement. Overall, the study proved the success of both mindful movement and MSR in increasing self-awareness and improving self-care and communication. Participants in both the programmes had greater physical self-awareness, study engagement and improved communication. The main conclusion from the finding was that both the meditation and movement based interventions provide additional benefits to psychology students. However, lack of tools to measure stress biomarkers and academic performance was identified as some limitation. The study recommended the need to use validated self-report scales in the future to assess level of stress and improvement in academic performance. Apart from this, other limitation of the study include small sample size which may affect the generalizability of the findings (Faber & Fonseca, 2014).

Research Design

In the context of application of the research in the scenario of Steve and Debbie, it can be said that the study is useful in addressing the query related to benefit of practicing mindfulness to reduce stress. As the study proved that mindfulness can promote well-being, reduce stress and improve study engagement, Steve can use the article to explain Debbie how practicing mindfulness can alleviate stress among university students. One factor that can enable application of the intervention to the scenario that the research has been done in university students and this make the intervention feasible to be used in the scenario. Other factors that can become enablers for the application of MSR in university students include raising awareness of the benefits of mindfulness by means of training. As students like Steve and Debbie may not have information on ways to use mindfulness to minimize stress, implementation of training programs for the same can be an appropriate strategy to enhance use of the intervention among university students. The study Galante et al. (2017) and Britton et al. (2012) has also revealed the scope of mindfulness intervention in alleviating stress and anxiety among university students. However, one barrier to the adaptation may be lack of time as this intervention requires student’s participant in MSR sessions many times. The evidence by Banerjee, Cavanagh and Strauss (2018) also reported about barriers to adherence to the mindful practice because of challenges in attending practice and lack of trust on the intervention. The lack of trust aspect is strengthened by this study as it gives convincing evidence to show the benefits of mindfulness on nurses. However, support by teachers is needed to address time related barriers.   

Conclusion

From the evaluation of the article by McConville et al. (2019), it can be concluded that the article is successful in addressing research gap and showing that mindfulness intervention can be beneficial for alleviating stress in university students. Some of the strengths of the article was the use of qualitative method to explore research data. However, some limitations of the study included small sample size and lack of use of validated scales to measure stress and improvement in academic performance. Thus, in future, quantitative approach may be useful in addressing the above research gap.     

References:      

Banerjee, M., Cavanagh, K., & Strauss, C. (2018). Barriers to mindfulness: A path analytic model exploring the role of rumination and worry in predicting psychological and physical engagement in an online mindfulness-based intervention. Mindfulness, 9(3), 980-992.

Britton, W. B., Shahar, B., Szepsenwol, O., & Jacobs, W. J. (2012). Mindfulness-based cognitive therapy improves emotional reactivity to social stress: results from a randomized controlled trial. Behavior therapy, 43(2), 365-380.  doi: 10.1016/j.beth.2011.08.006

Faber, J., & Fonseca, L. M. (2014). How sample size influences research outcomes. Dental press journal of orthodontics, 19(4), 27-29. doi: 10.1590/2176-9451.19.4.027-029.ebo

Galante, J., Jones, P., Dufour, G., Benton, A., Howarth, E., Vainre, M., ... & Stochl, J. (2017). A randomised controlled trial of the provision of a mindfulness intervention to support university students' wellbeing and resilience to stress: preliminary results. DOI:https://doi.org/10.1016/S0140-6736(16)32285-1

Garner, R., & Scott, G. M. (2013). Doing qualitative research: designs, methods, and techniques. Pearson Education. https://www.pearson.com/us/higher-education/program/Scott-Doing-Qualitative-Research-Designs-Methods-and-Techniques/PGM332776.html

Grossoehme, D. H. (2014). Overview of qualitative research. Journal of health care chaplaincy, 20(3), 109-122. doi: 10.1080/08854726.2014.925660

Janssen, M., Heerkens, Y., Kuijer, W., Van Der Heijden, B., & Engels, J. (2018). Effects of Mindfulness-Based Stress Reduction on employees' mental health: A systematic review. PloS one. doi: 10.1371/journal.pone.0191332  

King, N., Horrocks, C., & Brooks, J. (2018). Interviews in qualitative research. SAGE Publications Limited. https://books.google.co.in/books?hl=en&lr=&id=ZdB2DwAAQBAJ&oi=fnd&pg=PP1&dq=King,+N.,+Horrocks,+C.,+%26+Brooks,+J.+(2018).+Interviews+in+qualitative+research.+SAGE+Publications+Limited&ots=hvZr-azF-T&sig=BOdUiJVL3U73ZQtbVp3GT-QRnXQ&redir_esc=y#v=onepage&q&f=false

McConville, J., Lewis, D., Chambers, R., & Hassed, C. (2019). Physiotherapy student experience of a mindful movement and a mindful stress-reduction intervention: A qualitative study. New Zealand Journal of Physiotherapy, 47(3). DOI:10.15619/NZJP/47.3.05

Sharma, G. (2017). Pros and cons of different sampling techniques. International journal of applied research, 3(7), 749-752. https://www.allresearchjournal.com/archives/2017/vol3issue7/PartK/3-7-69-542.pdf

Shukla, A., & Supe, A. (2017). Authorship and Contributorship. In Writing and Publishing a Scientific Research Paper (pp. 133-141). Springer, Singapore. https://link.springer.com/chapter/10.1007/978-981-10-4720-6_13 https://link.springer.com/article/10.1007/s12671-017-0837-4

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