CITATION (Jadresic, Súarez, Palacios, Palacios & Matus, 2011).
STUDY PURPOSE
Was the purpose
stated clearly?
0 Yes
0 No
The purpose of this study was clear with its objective being the creation of an understanding of the effectiveness of using endoscopic sympathectomy in the treatment of facial blushing in combination with other treatments or on its own. It chose to do a comparison of endoscopic thoracic sympathectomy tor treatment of blushing and general social anxiety disorder and the use of sertraline treatment and cases of lack of treatment. This study is in line with my research question in that it helps in creating an understanding of the basis of blushing with connection to a form of social anxiety.
LITERATURE
Was relevant background literature reviewed?
0 Yes
0 No
The need for this study was that no past study has done a similar comparison for the determination of treatment of bushing. Blushing is a situation with psychological connections and symptomatic of social phobia and it can cause psychological suffering and interference with levels of performance. However, there has been little focus on the understanding of the role of Thoracoscopic sympathectomy until the introduction of endoscopic Thoracoscopic sympathectomy. This makes it reasonable to conduct research in the field for better understanding of the best means of treating the condition. There are several reports on the efficacy of the use of ETS in the treatment of blushing,. Nonetheless, the review of the research showed a lack of succinct inclusion or exclusion of the criteria of patients. There is also a gap in comparison of ETS and other possible treatments of facial blushing or without treatment. That made the study justifiable as the first to do a comparison of the efficacy of treating blushing and social anxiety using ETS and comparing with another form of treatment or with cases of no treatment. Therefore, the study chose to use the treatment of social anxiety disorder and blushing in comparison to using setraline.
DESIGN
0 Randomized (RCT)
0 cohort
0 single case design
0 before and after
0 case-control
0 cross-sectional
0 case study
The study design was appropriate as it consisted of psychiatric interviewing of patients seeking treatment for blushing issues. The social phobia scale was used for measuring the results. It was used for the measuring of general anxiety disorder and follow-ups after administration of sertraline conducted in an average of 11 months or endoscopic thoracic sympathectomy. The group under no treatment was that of blushers with mainly economical reasons hindering their taking up of surgery and those who did not respond to sertraline treatment. Having the research in real medical practice it was unethical having participants for research purposes since they were in dire need of medical attention.
SAMPLE
N =
Was the sample described in detail?
0 Yes
0 No
Was sample size
justified?
0 Yes
0 No
0 N/A
The research used a sample of 330 patients seeking treatment for blushing formed the sample for the study. The similarity in the sample was that they all went for consultations regarding their conditions of blushing.
OUTCOMES
Were the outcome
measures reliable?
0 Yes
0 No
0 Not addressed
The outcome was measurable showing a decline in the scores of Brief Social Phobia when treated or not treated. The statistical significance of treatment using endoscopic sympathectomy was (p=0.003).
INTERVENTION
Intervention was described in detail?
0 Yes
0 No
0 Not addressed
There was detail in the description of intervention for social blushing is embarrassing and an ideal approach would be timely treatment. Non-surgical treatment is important to avoid placebo effects of surgery. The non-surgical intervention can help in normal medical intervention for treatment of patients with blushing problems before the development of social anxiety disorder.
RESULTS
Results were reported in terms of statistical significance?
0 Yes
0 No
0 N/A
0 Not addressed
The results were statistically reported with baseline results showing severe blushing cases in 97 percent of those treated using endoscopic thoracic sympathectomy, 87 percent of the group treated using sertraline and 78percent of those who were not treated. This changed at follow up at 16 percent, 32 percent, and 57 percent of patients treated using endoscopic thoracic sympathectomy, those treated with sertraline and the untreated patients respectively.
Drop-outs were reported?
0 Yes
0 No
no
CONCLUSIONS AND IMPLICATIONS
Conclusions were appropriate given study methods and results
0 Yes
0 No
There was relevance of the conclusion given the methodology. Great reduction in blushing had an association with administration of endoscopic thoracic sympathectomy. This was same for the scores of Brief Social Phobia scales and the satisfaction with treatment as compared to the cases of no treatment and those that used sertraline.
CITATION (Davies, 1994)
STUDY PURPOSE
Was the purpose
stated clearly?
0 Yes
0 No
The purpose of this study was to create information that nurses can use to identify, assess and treat patients suffering from anxiety. It was focused on general anxiety disorder and the effects it has on the lives of individuals and on the general society. It was also aimed at provision of the capability of identification, description and treatment of anxiety. It also focused on highlighting the role of nurses in the assistance of patients having anxiety as well as presentation of discursive capabilities of evidence-based treatment of anxiety. It focused on the leadership roles of nurses in intensive care for the rehabilitation of elderly people. This study is relevant to my research question seeking to understand the general conditions and possible treatments of anxiety.
LITERATURE
Was relevant background literature reviewed?
0 Yes
0 No
The justification of this study lies on the undeniable role of nurses in the working with patients in management of anxiety. Apparently, anxiety is a common condition, but is rarely treated and some occasions undertreated. This follows a lack of detection and early intervention, leading to chronic cases, severity and presentation of multiple social, physical and psychological complications. Individuals are unaware of anxiety as a treatable condition, while health professionals are inadequately trained for recognition of associated symptoms and signs of anxiety. It results to coping with anxiety symptoms for unnecessarily longer periods and delays in treatment. Symptoms of anxiety vary from person to person and early detection can help in the reduction of cases of premature mortality making the need for early recognition of anxiety a necessary cause of study. Teamwork in elderly care can create positive therapeutic effects and it is a necessary change in enhancing the health of elderly people in wards.
DESIGN
0 Randomized (RCT)
0 cohort
0 single case design
0 before and after
0 case-control
0 cross-sectional
0 case study
The study design was appropriate for articulating the general issue of anxiety. There was a review of ample literature about anxiety. This incorporated adequate analysis of different aspects connected to anxiety such as phobias, post-traumatic stress disorder and phobias. It highlighted the symptoms and prevalence of anxiety as well as presentation of possible management of generalized anxiety. Further, the study focused on self-help and the role of nurses in the management of anxiety. The study used quasi-experimental design for the comparison of three variables between the ward of study and two other similar wards within the care unit. It also used semi structured interviews and qualitative data as well as observation of team members. The District Ethics Committee approved the research before its onset. All patients visitors and patients gave verbal consent before observation and interviews.
SAMPLE
N =
Was the sample described in detail?
0 Yes
0 No
Was sample size
justified?
0 Yes
0 No
0 N/A
The sample for pilot study was five nurses. The main research had 13 nurses, four doctors, two social workers and five therapists.
OUTCOMES
Were the outcome
measures reliable?
0 Yes
0 No
0 Not addressed
The outcome was an improvement in the study ward without differences in comparison ward.
INTERVENTION
Intervention was described in detail?
0 Yes
0 No
0 Not addressed
Introducing nurse-led care of elderly is a nursing development for progressive success in the rehabilitation of patients. Admission of patients in accordance to their needs helped in evaluating the performance of nurse teams in the implementation of care models for given patient groups; nurses stopped putting on uniforms and conducting of exhaustive assessments, as on ordinary cases. This was for the avoidance of what was termed as ‘unnecessary medicalisation’.
RESULTS
Results were reported in terms of statistical significance?
0 Yes
0 No
0 N/A
0 Not addressed
On the study of development of a nurse-led system, for team care on rehabilitation wards, the result was that regardless of earlier tensions, nurses accepted the changes and opened up to discussions and balance between disciplines. There were also better recordings of time scales, such as planning of discharge dates. Ward activities were also records and the quality of nursing care improved.
Drop-outs were reported?
0 Yes
0 No
No
CONCLUSIONS AND IMPLICATIONS
Conclusions were appropriate given study methods and results
0 Yes
0 No
The study was appropriate in that it did not interfere with daily operations in the wards, patient care and time of stay in the wards. In fact, it created an improvement in the quality of care making it reasonable to conclude that creating changes in running of caretaking creates an improvement. It was concluded that nurses empowered with leadership get prepared for implementing change and leading their teams. The quasi study was found out that the current crisis faced in the healthcare system could only be improved through implementation of carefully articulated nurse led programs for the co-ordination of patient care. Nurses spend much of their time with patients involving them in the planning and implementation of care approaches helps in creation of patient-centered focuses.
CITATION (Marriage, & Henderson, 2012).
STUDY PURPOSE
Was the purpose
stated clearly?
0 Yes
0 No
The objective of the study was to investigate how nurse delivered therapy affects the management of anxiety and the quality of life of asthmatic children within the society.
LITERATURE
Was relevant background literature reviewed?
0 Yes
0 No
The limited literature on psychological interventions for asthmatic children created a gap in need of filling using more research. The study sizes of past studies were small and only two studies conducted a meta-analysis for the examination of how relaxation therapy affects the peak flow rates. The researchers concluded that the results were inadequate in making any firm conclusions about the role of psychological treatment of asthmatic children giving room for further research in the field. Another reason for the need of the research lay in the complexity of understanding emotional issues and the complications it has on coexistence. Since children suffering from asthma and anxiety need frequent consultation with healthcare professionals, it is important for parents and caretakers to remain proactive in the response to unplanned hospital visits and admissions. The children also need to learn to cope with lost school time and disruptions of normal livelihoods.
DESIGN
0 Randomized (RCT)
0 cohort
0 single case design
0 before and after
0 case-control
0 cross-sectional
0 case study
The study incorporated a pilot study of ten children of ages 7-10. These children were having asthma as well as anxiety issues related to health. Data collection took place within a period of two years with provision of cognitive behavior therapy. The sessions measured anxiety, asthma and a number of quality life aspects. The study had a selection of scoring tools for the evaluation of beneficial effects in nurse-led cognitive behavioral approach for reduction of asthma, quality of life and anxiety. The study included three months training by CAMHS of nurse specialists. All children received cognitive behavior therapy (CBT) course. The ethics committee for local research gave an ethical approval. The participants were selected out of consent from their parents with all children signing an assent form and an assurance form the researchers to ensure privacy and confidentiality during the entire process.
SAMPLE
N =
Was the sample described in detail?
0 Yes
0 No
Was sample size
justified?
0 Yes
0 No
0 N/A
The sample of the study was children under tertiary care in a respiratory clinic. They did not meet CAMHS threshold but were in need for medical intervention.
OUTCOMES
Were the outcome
measures reliable?
0 Yes
0 No
0 Not addressed
The administration of Child and Adolescent Mental Health Services led to improvement of the quality of life. The enhancement of this had further contribution from nurse-delivery and programs in cognitive behavioral therapy. The result was increase in hyperventilation scores and anxiety levels decreased.
INTERVENTION
Intervention was described in detail?
0 Yes
0 No
0 Not addressed
Research on behavioral therapeutic intervention for children having asthma and their coexistence in the society is a proactive approach towards the improvement of the quality of life. The intervention can be used in the normal medical setting so that children learn important behavioral techniques and nurses understand their roles in the lives of children with asthma and anxiety complications. Through adaptation of cognitive coping skills, the children will reports less symptoms of asthma and anxiety and have improvements in their life quality.
RESULTS
Results were reported in terms of statistical significance?
0 Yes
0 No
0 N/A
0 Not addressed
Out of the initial seventeen children selected for the study, only ten maintained the process.
Drop-outs were reported?
0 Yes
0 No
Yes. Four children dropped after session one, two after session two and the last one after session four making a total of seven dropouts. One child could not continue sessions because of the distance between the hospital and her home, two found the intervention unhelpful, and four gave no reason for dropping our of the study.
CONCLUSIONS AND IMPLICATIONS
Conclusions were appropriate given study methods and results
0 Yes
0 No
According to the study conducted the conclusion was that it is necessary for nurses to understand their role in the management of anxiety as a negative implication on the quality of life of children with asthma. This called for early intervention of symptoms of anxiety and early address of the condition. Having a nurse-led clinic is effective for the reduction of anxiety in children having asthma and improving coexistence of anxiety. Specialist nurses are capable of offering holistic medical care. The intervention is adaptable to other chronic illness applications and creation of awareness of the effects of anxiety in asthma management in multiple healthcare management settings.
CITATION (Neville & Teri, 2011).
STUDY PURPOSE
Was the purpose
stated clearly?
0 Yes
0 No
The objective of the study was aimed at reporting the prevalence of anxiety symptoms and anxiety as well as creating knowledge on factors related to anxiety. It was focused at producing information regarding anxiety within the study population and creating a clarification of the relationship anxiety has with factors such as dementia for the creation of possible treatment interventions and avenues.
LITERATURE
Was relevant background literature reviewed?
0 Yes
0 No
Assisted living facilities for old people having dementia are taken care of by nursing aides and healthcare workers such as mental health nurses and community healthcare nurses offer consulting advice and treatment. Old people having dementia exhibit anxiety symptoms and its prevalence rate in old people living with dementia in assisted living facilities is reported in most occasions. Previous studies have used non-specific measures with subscales for anxiety with limited association of anxiety and dementia. There lacks information of association of dementia and anxiety in assisted living facilities leaves out the possibilities of possible interventions.
DESIGN
0 Randomized (RCT)
0 cohort
0 single case design
0 before and after
0 case-control
0 cross-sectional
0 case study
The study type was cross-sectional design, which made a combination of baseline data from previous studies. This was limiting to the study since there was also a reliance on staff reports for CAS and RAID, while it would be more productive to use direct observation by a professional. The project had an ethical approval accorded by the University of Washington, Rush university and University of Arkansas reviews board. Signed consents were received from participants and from legal guardians for those with cognitive impairments.
SAMPLE
N =
Was the sample described in detail?
0 Yes
0 No
Was sample size
justified?
0 Yes
0 No
0 N/A
The sample size used for the research was big enough for the production of viable results. It was in line with studying of old people having dementia. In addition, the study setting was well defined with relevant instruments’ for the process. The study uses a sample of 148 people relevant for exploratory and descriptive analysis used in the study.
OUTCOMES
Were the outcome
measures reliable?
0 Yes
0 No
0 Not addressed
The outcomes measures were reliable and in line with previous studies giving enough reason for the need of assessment and treatment of anxiety on old people living with dementia in assisted living facilities. There is a likeliness that behavioral symptoms stress staffs and influences their reactions to the symptoms and that in turn heightens the anxiety of assisted living facility residents.
INTERVENTION
Intervention was described in detail?
0 Yes
0 No
0 Not addressed
Strengthening of staff competence through comprehensive education of health practitioners is helpful in the management of behavioral symptoms. It also enhances the capability of nurses in the identification of signs and symptoms associated with anxiety for determination of required treatments. This is important for application to real life health care for old people having dementia to avoid cases of early relapse, delayed remission and recurrence.
RESULTS
Results were reported in terms of statistical significance?
0 Yes
0 No
0 N/A
0 Not addressed
This being the first study using dementia specific instruments, the results were relevant in helping in the examination of the prevalence anxiety associated factors in old people having dementia within assisted living facilities. The result was that anxiety and symptoms of anxiety is prevalent in this setting and that behavioral symptoms, staff reactions, depression and the competence of caring have strong association with dementia. The report had statistical significance with the rate of prevalence of anxiety for old people living in assisted living facilities being higher that the recorded for the sample in community settings.
Drop-outs were reported?
0 Yes
0 No
no
CONCLUSIONS AND IMPLICATIONS
Conclusions were appropriate given study methods and results
0 Yes
0 No
Enhancing the role of nurses through assurance of their mental health stability and the overall mental health of practitioners is instrumental for the improvement for improving of the health of old people having dementia. This study gave information for the improvement of mental health of nurses and that of healthcare nurse practitioners for targeting of treatment. The information can be used for training of healthcare professionals working in assisted living facilities to be capable of involvement in assessment, planning and evaluation of care processes. Behavioral symptoms lead to adverse reactions of facility staffs and that produces certain reactions, which increase the anxiety of facility residents. This influences the competence of facility staffs and creates a close link with residents of facilities.
CITATION (Singer, Cardenas, Xavier, Jeanty, Pereyra, Rodriguez & Metsch, 2012).
STUDY PURPOSE
Was the purpose
stated clearly?
0 Yes
0 No
The study focused on identification of factors relating to dental anxiety among populations of HIV people in primary care. It also studied the association of dental anxiety and the use of the services of healthcare.
LITERATURE
Was relevant background literature reviewed?
0 Yes
0 No
Oral healthcare is one of the highly ranked health conditions suffered by people having immunodeficiency virus (HIV). This is proven by several past studies with reports of HIV positive individuals having unmet oral health medical support as compared to negative people. HIV people develop cases of oral lesions with a high prevalence in periods before the development of HAART and a reduction of oral cases after its development. Moreover, low CD4 cell counts lead to regular development of oral lesions in people living with HIV. This can lead to a negative impact on the health of these individuals if not promptly tackled. According to studies, dental examiners are proactive in identification of dental problems in those with HIV. However, there dental anxiety is one of the barriers reported to deter people from seeking dental care. Dental anxiety causes delay in seeking intervention and leads to avoidance behavior. Because of dental anxiety, many HIV individuals avoid healthcare out of fear. However, there is little knowledge regarding dental anxiety prevalence among populations of HIV individuals. That made the study justifiable to create insight regarding the issue.
DESIGN
0 Randomized (RCT)
0 cohort
0 single case design
0 before and after
0 case-control
0 cross-sectional
0 case study
A cross –sectional design was used for the study with data collection taken from a sample of HIV patients. Trained study staffs presented themselves in HIV care clinics during the study period. Project staffs had strict ethical guidelines to following line with expected conduct for obtaining consent and maintaining confidentiality during the process.
SAMPLE
N =
Was the sample described in detail?
0 Yes
0 No
Was sample size
justified?
0 Yes
0 No
0 N/A
Sampling (who; characteristics; how many; how was sampling done?) If more than one group, was there similarity between the groups?:
The study sample was 476 individuals. Between the duration of March and October 2010. The sample comprised of people living with HIV. However, the data was from a large town leaving the researchers to generalize possible results to HIV individuals in rural areas. It also focused on self reports and that could have some limitations within the reporting.
OUTCOMES
Were the outcome
measures reliable?
0 Yes
0 No
0 Not addressed
Those attending primary healthcare for HIV intervention rarely seek dental care intervention. There is negative impact on HIV positive individuals caused by dental anxiety.
INTERVENTION
Intervention was described in detail?
0 Yes
0 No
0 Not addressed
The intervention used was on a primary care unit with detailed procedure for handling of patients described clearly.
RESULTS
Results were reported in terms of statistical significance?
0 Yes
0 No
0 N/A
0 Not addressed
The results showed that there was an association of dental anxiety and decrease in using dental healthcare services. The results was proof that there is need for screening of HIV positive people for dentalanxiety.
Drop-outs were reported?
0 Yes
0 No
32 of those enrolled declined participation in the study while some of them gave incomplete data.
CONCLUSIONS AND IMPLICATIONS
Conclusions were appropriate given study methods and results
0 Yes
0 No
The findings on the role of HIV on dental anxiety is an important aspect making it important for health professional to be proactive in encouraging dental assessment of patients visiting HIV clinics. Healthcare providers have the opportunity for influencing the behavior of patients and encouraging positive consideration of dental care. They can as well offer dental care referrals in line with the need for initial and interim physical examination for HIV positive individuals. Sensitization of primary care providers with the need of ensuring dental health enhances the reinforcement of focus on the need for routine dental checkups within HIV care units and that will promote early interventions for dental anxiety related issues. Such an intervention is practical and inexpensive.
References
Davies, S. M. (1994). An evaluation of nurse-led team care within a rehabilitation ward for elderly people. Journal Of Clinical Nursing, 3(1), 25-33. doi:10.1111/1365 2702.ep11552446
Jadresic, E., Súarez, C., Palacios, E., Palacios, F., & Matus, P. (2011). Evaluating the Efficacy of Endoscopic Thoracic Sympathectomy for Generalized Social Anxiety Disorder with Blushing Complaints: A Comparison with Sertraline and No Treatment-Santiago de Chile 2003-2009. Innovations In Clinical Neuroscience, 8(11), 24-35.
Marriage, D., & Henderson, J. (2012). Cognitive behaviour therapy for anxiety in children with asthma. Nursing Children & Young People, 24(9), 30-34.
Neville, C., & Teri, L. (2011). Anxiety, anxiety symptoms, and associations among older people with dementia in assisted-living facilities. International Journal Of Mental Health Nursing, 20(3), 195-201. doi:10.1111/j.1447-0349.2010.00724.x
Singer, R., Cardenas, G., Xavier, J., Jeanty, Y., Pereyra, M., Rodriguez, A., & Metsch, L. R. (2012). Dental Anxiety and the Use of Oral Health Services Among People Attending Two HIV Primary Care Clinics in Miami. Public Health Reports, 127(S2), 36-44.
