Physical Activity in Older Adults with Schizophrenia

PhysicalActivity in Older Adults with Schizophrenia

PhysicalActivity in Older Adults with Schizophrenia

  1. Is the title representative of the research report?

Yes.The title ‘‘It’sGood for Me’’: Physical Activity in Older Adults withSchizophrenia”is appropriate for the research report as provides a proper overviewregarding the contents of the report. Indeed, a cursory glance at thetitle is enough to help the reader know that the report would bedealing with the views of older adults with schizophrenia on physicalactivity. The first statement shows that they agree that it isadvantageous to them.

  1. Does the introduction state the problem and address its importance to nursing?

Yes.Right from the beginning, the authors present data and statistics onyoung and old individuals suffering from schizophrenia and go aheadto offer a definition of physical function and its effects on healthand quality of life. They then underline the importance of physicalactivity to treatment of older individuals with the condition in aneffort to enhance physical function.

Nevertheless,the significance of the research to nursing in the introductionrather it is covered in the conclusion where the authors state thathealthcare providers should consider a shift from focusing on mentalhealth to physical health as a treatment for the condition.

  1. Is the literature review thorough and reflect critical analysis?

Yes.While the article does not incorporate a distinctly labeledliterature review section, it incorporates a critical analysis ofprevious works that are relevant to the subject at hand, therebycreating a foundation for the comprehension of the problem at hand.

  1. Are the research questions and/or hypotheses clearly written?

No.The article does not outline the research questions and hypothesis ofthe study was not stated. However, there is a clear statement of theresearch purpose, which is to outline the views of older adults withschizophrenia regarding facilitators and barriers to taking part inphysical functions.

  1. Was the theoretical basis or perspective for the study described?

Yes.The theoretical basis for the study was clearly stated as theGrounded theory. This has its framework as symbolic interactionism,which states that the understandings of individuals take place in thecontext of relationships.

  1. Was the type of qualitative study design described?

Maybe.The article does not really describe the design of the qualitativestudy but rather states that once the consent of the participants andthe approval of the institutional review board had been acquired, theparticipants were interviewed in one-on-one format or small groups.

  1. Was the setting used to collect the data described?

Yes.In the study, the participants were recruited from locked residentialfacilities, intensive case management program and a transitionalresidential and day treatment center.

  1. Are the population and sample under study clearly described?

Yes.This is described in the inclusion criteria where only individualsaged more than 55 and suffering from schizophrenia are included inthe study.

  1. Was the process for consenting the participants described?

No.The paper does not incorporate any description regarding the processused to obtain consent from the participants. It states, however,that the participants were selected on the basis of an evaluation oftheir understanding of the consent form.

  1. Were the inclusion and exclusion criteria described?

Yes.The authors clearly state that the selection of the participants wasbased on three criteria including age (55 and above), diagnosed withschizoaffective disorder or schizophrenia and capacity to comprehendthe provisions of the content form.

  1. Were the inclusion and exclusion criteria justified by the authors?

No.The authors simply outline the criteria that they use to selecteligible participants but not the justification for the same.However, the criteria are simple enough for the reader to know whythe researchers would settle for them

  1. Was the research protocol and data collection methods clearly described?

Yes.The authors state that the data collection involved in-depthone-on-one interviews and focus group interview carried out by thelead investigator, with the interviews being carried out in locationsconvenient to the participants. However, data collection and analysiswere carried out simultaneously, using a constant comparison analysisapproach.

  1. Was the process for analyzing data described in detail?

Yes.The authors state that a constant comparison analysis approach wasused, with data from interviews being entered into the atlas.tiversion 6.2 software so as to enhance data organization. Astep-by-step description of the process offers a clear picturepertaining to the manner in which the analysis was carried out.

  1. Did the authors describe strategies to ensure rigor and prevent personal bias in the data analysis?

Yes.The authors state that the interviews were not only transcribedverbatim but also checked so as to verify the accuracy oftranscription.

  1. Were findings from the study supported by clear and complete examples?

Yes.The results of the study are clearly supported by exact statements ofthe participants recorded verbatim.

  1. Did the authors’ provide rich, detailed descriptions of the themes that emerged from the data?

Yes.The authors come up with clear and detailed descriptions pertainingto the emerging themes from the data. These included companionshippromoted PA, pride from being fit, connecting with others, necessarysense of accomplishment, belonging, comfort and safety, and mentalhealth among others. all these are supported by verbatim recordedstatements from the participants.

  1. Were the limitations of the study discussed?

Yes.The study interviewed patients in restricted geographical urban area,in which case it may be difficult to generalize to othersparticularly with regard to the form of physical exercises that arepracticed. Further, the participants in the study were taking part inmental health treatment programs, in which case the incorporation ofpatients that are less involved in the similarly structured treatmentprograms could yield varied barriers and facilitators to the physicalactivity.

  1. Does the discussion section match the result of the study? (Does it include a discussion of the results as they relate to the research questions, the theoretical framework, and the relationship to other published studies?)

Yes.The discussion section is in line with the results of the study. Itis noted that the facilitators and barriers that were identifiedcould be common to older adults that suffer from schizophrenia as aresult of distinctive issues such as cognitive deficits associatedwith the condition or even the condition itself. These barriers andfacilitators were the same ones identified as emerging themes in thestudy.

  1. Did the overall study meet its stated purpose? What does it add to the current body of knowledge?

Yes.The main purpose of the research was to outline the views of olderadults with schizophrenia regarding facilitators and barriers totaking part in physical functions. The current research not onlymanages to get the views and perspectives of the older adultssuffering from schizophrenia regarding physical activity, but alsocome up with themes pertaining to the facilitators and barriers forengaging in the same.

  1. Are the implications for nursing practice discussed?

Maybe.There is no clear discussion regarding the implications of researchfindings on nursing practice. However, the authors underlines theimportance of offering patient and staff education concentrating onthe psychological and physiological benefits of PA, as well as thenecessity for the two parties to shift their focus from enhancing themental health for a large proportion of their lives and insteadconcentrate more on physical health.

  1. Are implications for nursing research discussed?

Maybe.The authors state that this is the first paper to their knowledgethat qualitatively explores older adults (suffering fromschizophrenia) perceptions regarding the barriers and facilitatorsfor engaging in physical activities.

  1. Will you be able to apply the results from this study to your patient care?

Yes.The findings or results outlined in this study are pretty muchapplicable to nursing practice. This is particularly for theinformation pertaining to the facilitators and barriers to physicalactivity among older people suffering from schizophrenia. Thebarriers and facilitators would allow for the creation of theappropriate environment that would enhance the participation of theolder people in physical activities. For instance, a specialgymnasium where only such people are allowed would be appropriate asthere is likely to be less stigma.

“YogaBreathing for Cancer Chemotherapy–Associated Symptoms and Qualityof Life: Results of a Pilot Randomized Controlled Trial”

  1. Is the title representative of the research report?

Yes.The study aimed at assessing the feasibility and test the effects ofpranayama (yoga) on the quality of life and any associated symptomsof cancer. A cursory glance at the title would be enough to relaythis information to the reader.

  1. Does the introduction state the problem and address its significance to nursing?

Yes.In the introduction, the authors indicate that cancer chemotherapyusually has devastating systems. Unfortunately, there has been littleprogress regarding interventions that would effectively managesymptoms. Medications aimed at achieving this often have side effectsapart from being costly and ineffective. On the other hand,behavioral interventions are inexpensive an deficient of sideeffects.

  1. Is the review of the literature thorough and reflect critical analysis?

Maybe.The paper does not incorporate a distinctive literature reviewsection, rather this is accomplished in the introduction. However,even this only manages to offer information pertaining to yoga andhow it is done, rather than its effects on patients with cancer.

  1. Are the research questions and/or hypotheses clearly written?

No.The article does not clearly state the research questions and thehypothesis rather it simply states the aim of the study, which is toevaluate the effectiveness of yoga breathing methods among patientsundergoing chemotherapy so as to test its effectiveness inalleviating the symptoms of the ailment.

  1. Are the independent and dependent variables identified?

No.while there is a mention of the use of t-test for continuousvariables and x2 test for categorical variables in analysis ofpatient traits, nothing is said regarding what characteristics fallin either dependent and independent variables category.

  1. Was the methodological design described?

Yes.The study was a randomized controlled clinical trial that aimed atcomparing pranayama to usual care.

  1. Was the setting used to collect the data described?

Yes.This study was carried out in a university medical center.

  1. Are the population and the sample under study clearly described?

Yes.The population under study was composed of patients suffering fromcancer. The participants had to be receiving cancer chemotherapy.

  1. Was the process for consenting participants described?

No.While the authors clearly state that the informed consent wasobtained from participants, there is no description of the processused in obtaining the same.

  1. Were the inclusion and exclusion criteria described?

Yes.The inclusion criteria is stated as entailing reception ofintravenous chemotherapy for a diagnosis of cancer, Karnofskyperformance Status of 60 or more, a minimum of 4/10 score for fatiguein the analog scale score. The exclusion criteria is also stated.Participants were excluded in instances where they had already beentaking part in yoga, suffering from Childe C cirrhosis, class III orIV heart failure, severe chronic obstructive pulmonary disease,end-stage renal disease or even having undergone more than threeprior chemotherapy regimes.

  1. Were the inclusion and exclusion criteria justified by the authors?

No.the authors simply outline the inclusion and exclusion criteriawithout any justification for the same.

  1. Is the sample size described with support for sufficient size (i.e. rationale or power analysis)?

Maybe.In the study, a total of 46 participants were screened, with only 23being enrolled and randomized. Further 5 of them withdrew afterrandomization for varied reason. While a similar study had never beendone, a sample of 18 individuals may not be sufficiently large.

  1. Were the instruments or physiologic tools/measures used to measure variables described?

Yes.Varied physiologic measures or tools used in measuring variables areoutlined. For instance, fatigue was measured with the use of revisedPiper fatigue Scale, while depression and anxiety were measured using14-item Hospital Anxiety and Depression scale (HADS). General SleepDisturbance Scale was used in measuring sleep disturbance, whilePerceived Stress Scale was used in measuring stress.

  1. Was support for the reliability and validity of measurement instruments described?

Maybe.The reliability and validity of GSDS was clearly stated while noindication of the same is made in the case of the other measures.

  1. Was the research protocol clearly described?

Yes.the participants completed study treatment and daily home pranayamapractice that averaged 3.2 hours/week and 2.4 hours/week for thetreatment and control group.

  1. Was information about the data analysis provided?

Yes.Data analysis was carried out using t-tests and x2-tests in an effortto determine the between-group differences. Further,repeated-measures analysis were carried out on the QOL and symptommeasures using multi-level mixed effects linear regression.

  1. Were the statistical tests appropriate for the study design? ( Do they provide information to answer the research questions/ hypotheses? )

Yes.The tests were selected as they allowed every available datapertaining to the participants in the study design to undergoanalysis.

  1. Were the results of the study described?

Yes.the exercises resulted in an improvement of the cancer symptoms forthe patients in chemotherapy.

  1. Were the limitations of the study discussed?

Yes.The small sample size comes as the most dominant, coupled with thelikelihood of selection bias that comes into play as a result ofindividuals that chose to take part in the study. Further, the studyrelied on self-reported outcomes.

  1. Does the discussion section match the results of the study? (Does it include a discussion of the results as they relate to the research questions/hypotheses, and the relationship to other published studies?)

Yes.The comprehensive discussion incorporates information regarding theresults and states that an increase in yoga breathing practiceresulted in enhanced QOL scores and improved symptoms. This wasconsistent with the results outlined in the findings section.

  1. Are the implications for nursing practice discussed?

Maybe.While the implications of findings in nursing practice are yet to bediscussed, it is obvious that the results would come in handy ineliminating or lowering the negative symptoms of cancer amongindividuals.

  1. Are implications for nursing research discussed?

Yes.The authors clearly state the gaps that were present in the priorliterature, thereby outlining the implications on nursing research.For instance, prior research studies had concentrated on thebreathing exercise only, while this article takes into considerationdifferent activities.

  1. Will you be able to apply the results from this study to your patient care?

Yes.Perhaps it would be advisable to combine pharmacologicalinterventions with behavioral interventions or even have the formercompletely replaced by the later.

References

Dhruva,A., Miaskowski, C., Abrams, D., Acree, M., Cooper, B., Goodman, S &ampHecht, F (2012). Yoga Breathing for Cancer Chemotherapy–AssociatedSymptoms and Quality of Life: Results of a Pilot RandomizedControlled Trial. TheJournal Of Alternative And Complementary MedicineVolume 18, Number 5, 2012, pp. 473–479

Leutwyler,H., Hubbard, E.M., Slater, M &amp Jeste, D.V (2014). ‘‘It’sGood for Me’’: Physical Activity in Older Adults withSchizophrenia. CommunityMent Health J50:75–80