Wednesday, December 4, 2019

Foundations of Research and Evidence Based Practice

Question: Discuss about the Foundations of Research and Evidence Based Practice. Answer: Introduction With the advancement in science and technologies the quality of human lives has been improved significantly and in current scenarios the human beings can easily do there requisite tasks without any hassle. As a result, the human has become lazy and avoid hard work and for reason the modern human tend to be unfit and prone to several diseases. Moreover, among the several dreadful diseases back pain is one of the vital diseases and most common in the modern public. There are many people, who suffer from chronic back pain and few of them usually not shows significant improvement with the regular therapies (Cashin Cook, 2011). Acupuncture is a traditional Chinese therapy, and it is heard that it has significant effect on several different acute diseases as well as for the pain it has substantial effect so that the research is on whether it is a worthwhile treatment for the patients with low back pain or not. Main body The impact that has been arisen currently depicts several stories and myth circulated all over the field of healthcare and wellbeing program, where the physicians and healthcare practitioners greatly discuss on this topic; on the effect of acupuncture on the human body. Acupuncture mainly deal with some important points in human body, those are liable for the functions of several different organ of human body. The chronic back is one of the worst back pain problems with depicting the signs of cancer in some cases. The acupuncture is the best instrument which is used for reducing the back pain and henceforth it is considered for the treatment. Acupuncture helps in the improvement of the digestion system in the body and thereby it helps to get relief from the back pain. For this reason the acupuncture is used for the treatment of chronic back pain. Moreover, according to the perceptions of the acupuncturists systematic pressure on the acupuncture point improve the body function effecti vely so that play important role in curing the patients, who suffers from several different types of acute diseases. In the current situation, there are several patients, who suffers from the acute back pain and the main cause of the disease is laziness of the modern people, with improving life style the human being has become lazy and need more luxury and these lead them into several diseases and back pain is one of them, which is most common in modern human beings. As a healthcare practitioner I have to face several cases, where the patients are suffering from acute back pain and the usual treatments have not any significant effect on them. It relieves them for the time beings but not cure them permanently. Therefore, the necessity of an alternative treatment is emerging and so that the reference of acupuncture therapy is coming as it is heavily discussed in healthcare field among the public related to healthcare such as the physicians, healthcare practitioners and patients (Krali k, Trowbridge, Smith, 2008). Moreover, it is widely discussed that it has no side effect on the human body and it has only positive effect on human body. Conclusion As, I have faced several patients who are suffering from acute back pain and I observed that the usual Allopathic treatments have not significant effect on the these patients as it provide short term relieves to the patients of acute back pain and the problem of the patients remain with them and the usual treatment cannot cure the back pain in permanent basis thus, I have to search for alternative treatment and so I choose acupuncture therapy. Part A, Section 2: Formulate a PICO In order to investigate the effect of the treatment on the patients, PICO is an effective instrument that helps in assessing the condition of the patients as well as the effect of the treatment on the patients. It is one of the most effective as well as popular tools among the people of nursing profession as it provide effective outcome that help in effectively evaluate the condition of the patients and the effect of the treatment on the patients (Polit Beck, 2012). For this undertaken matter a PICO is included and by the PICO the result and understanding will be generated that, whether acupuncture is effective in acute back pain or not. For this reason I have collected the response of the patients of acute back pain to the acupuncture therapy and their responses has been put into the popular and effective tool PICO. The results of PICO has been determined and evaluated about whether acupuncture is an effective intervention for chronic low back pain. In the research study, 58 participants have been selected for examining the effectiveness of acupuncture. Population The age of the participants is above 18 that will help to assess the diagnosis pattern including treatment and concordance within a clinical trial of acupuncture for the low back pain. Intervention In a controlled pragmatic randomized clinical trail, 58 patients with low back pain in between 4 weeks and 11 months duration were offered acupuncture randomly. Treatment and standardized diagnosis were completed by the practitioners. The diagnosis was based on low back pain syndromes. One of the practitionerss then re-examined the patients effectively. The inter rater reliability diagnostic was assessed in terms of congruent classifications. Comparison All groups were involved for comparison. The focus was on physical therapy rather than the structured exercise. Outcome The diagnosed syndrome that was most commonly associated with the low back pain was blood stagnation and Qi followed by Bi syndrome and kidney deficiency being more than one syndrome being determined for 66% of the patients. The practitioner has examined the patients concordance was reasonable which was between 80% and 47 of the classifications while values of Kappa lay between 0 and 0.67. The practitioner has provided 158 treatments in total using 188 different acupuncture methods. The most commonly channels used were gall bladder and bladder and the commonest point was BL-23 ad two points of Huatuojijaji. The practitioners have also used Auxiliary treatments to varying degrees. Therefore, Acupuncture is considered as the most effective treatment for low back pains. The diagnostic concordance among the practitioners was clear and reasonable themes emerged for the treatment. According to the result of PICO it is observed that the acupuncture therapy is effective in the treatment if the acute back pain as it significantly improves the condition of the patients and so that it provides much more relieves to the patients and its effects are for long term and permanent as it completely cure the diseases from the patients. Besides this, it is also observed that it has not any significant side effect on the patients. Therefore, the acupuncture is effective in acute back pain and it could be given to the patients of acute back pain. Part A, Section 3: Advance search in CINAHL The advanced search on the CINAHL is based on the search of the broader database which helps in the creation of focus on the PICO measurements that are taken for the consideration of the study of CINAHL in the context of full text. It includes the following criterias of the assessment that must be completed for the enhancement of the research process and thereby it provides the focus on the undertaken scenario taken for the study. The scenario that is taken for the study focuses on the chronic low back pain which is seemed to be improved with the help of the usage of acupuncture (C. Lawrence, 2016). The treatment is provided in the form of the literature with providing the symbols of the low back pain and thereby the strategies are focused for mitigating the disease low back pain. The CINAHL process of the research is conducted for the achievement of the good source with conducting qualitative process for the collection of the instrument used for curing the disease. With the consideration of the retrospective analysis, the investigation of the CINAHLs potential contribution is identified with the consideration of the research and thereby the studies are created by the unique database with the consideration of the CINAHL database up gradation and preparation. With the consideration of the 58 quantitative reviews, about 43 reviews are selected which thereby helps in the consideration of the successful study for the research. The 43 reviews are found to be ill and thereby the consideration of the study provides the final synthesis of the CINAHL database. With the consideration of the database, the reviews that are notified seemed to be 11 reviews with the identification of the study for the database and thereby the median helps in the identification of about 9.09 % while the lowest value is 5 % to the highest value is about 33% (Lawrence, 2007). The rigorous strategies are included for the acute collection of the index regarding the case scenario and thereby the limited number of reviews is created with the creation of systematic reviews. The CINAHL process provides the step by step process with the creation of enhancement of the study of the scenario mentioned. The instruction provides the appropriate approach for the enhancement of the acupuncture which is used for the chronic low back pain. It provides the approaches that must be covered in the part of the Medline and thereby the focus is created for the development of the database. The CINAHL database provides the appropriate approaches with the conducted research that consists of the process of CINAHL which includes the Embase, Medline and the Database formation of the diseases with the preferred treatments. The studies that are included helps in the consideration of the criteria of PICO which are as follows:- Consideration of the individuals with the CLBP defined with the time duration of 12 weeks or longer. Prescribed exercise and the monitoring of the health care as prescribed and monitored by CLBP and health care practitioner (Wright, Golder, Lewis-Light, 2015). Randomizing the controlled trials. Measuring the clinical outcomes regarding pain and advising the patient regarding the pain reduction and improving function. The determination that is made provides focus with the creation of the enhancement for the controlling of the criteria developed and thereby it also helps in the creation of development criteria for the enhancement and also the systematic review is considered. Henceforth the disability of the outcomes are not identified instead fruitful outcomes are identified with the utilization of the evidence that are created regarding the pain scales. Henceforth the intervention criteria is seemed to be more effective in the case of the back pain and thereby the systematic review is created with the further continuation of the treatment considered for CLBP. The retrospective formation of the physiotherapy is used with the creation of the quality assessment tool with thereby also helps in the creation of internal validity and thereby the increment of statistical value is also seen regarding RCT controlled trials used by the usage of acupuncture. References Cashin, A. Cook, R. (2011).Evidence-based practice in nursing informatics. Hershey, PA: Medical Information Science Reference. Kralik, D., Trowbridge, K., Smith, J. (2008).A practice manual for community nursing in Australia. Oxford: Wiley-Blackwell. Polit, D. Beck, C. (2012).Nursing research. Philadelphia: Wolters Kluwer Health/Lippincott Williams Wilkins. Lawrence, J. (2016).WSU Library - EzProxy.Www-clinicalkey-com-au.ezproxy.uws.edu.au. Retrieved 3 September 2016, from https://www-clinicalkey-com-au.ezproxy.uws.edu.au/#!/content/journal/1-s2.0-S0001209207601537 Lawrence, J. (2007). Techniques for Searching the CINAHL Database Using the EBSCO Interface.AORN Journal,85(4), 779-791. https://dx.doi.org/10.1016/s0001-2092(07)60153-7 Wright, K., Golder, S., Lewis-Light, K. (2015). What value is the CINAHL database when searching for systematic reviews of qualitative studies?.Systematic Reviews,4(1). https://dx.doi.org/10.1186/s13643-015-0069-4

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