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Critiqued Research Report

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Critiqued Research Report
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Critiqued Research Report Homsey, M., & O’Connell, K. (2012). “Use and success of pharmacologic and non-pharmacologic strategies for sleep problems.” Journal of the American Academy of Nurse Practitioners, 24, 612–623.
Introduction
Is the research problem clearly identified? Does it have significance to nursing?
The research problem is clearly identified because insomnia is an issue, in various individuals across the globe. Insomnia affects people’s productivity, causes stress, impairs relationship with others and interacts with routine work. Understanding the strategies that alleviate insomnia would be of prime importance in implementing care strategies in such individuals.
The research has significance to nursing because nursing personnel should render a person-centric care and hence, understanding the profile of a patient will help in designing specific strategies to alleviate insomnia.
Is there a clearly stated research question or hypothesis?
The research question is clearly stated since it wanted to evaluate the used and perceived successful strategies that alleviated insomnia. The research further evaluated the correlation of alleviation strategies on age, gender, income and education.
Review of the Literature
Does the literature review provide a synthesis of evidence about the research problem?
The literature review provided an adequate synthesis of evidence about the research problem. First of all the review endorsed that insomnia arises from significant anxiety and distress along with some organic causes.

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10-15% of individuals suffering from insomnia reported it as a chronic problem and a similar percentage of individuals the effect of insomnia in causing fatigue, difficulty in concentration and irritability (Riemann & Perlis, 2009). Moreover, insomnia was related to increased blood pressure, accident proneness, depression and an overall decrease in the quality of life. Thus, the review clearly unfolded the issues about insomnia and very well presented the need for evaluating alleviation strategies. The review also indicated that insomnia should be properly managed otherwise it may create serious health hazards (Reeve & Bailes, 2010).
The pharmacologic and non-pharmacologic interventions that are presently used to manage insomnia are clearly stated. The review endorsed that pharmacological interventions with non-benzodiazepines and anti-depressants are currently recognized as the most preferred agents to alleviate insomnia. However, the review equally stressed the utility of non-pharmacological interventions like Cognitive Behavioral Therapy in managing insomnia. This is important because insomnia has been strongly correlated with stress. Hence, mental conditioning through behavioral therapies like Yoga may act as effective alleviating strategies to combat insomnia (Riemann & Perlis, 2009).
Are gaps and conflicts in the knowledge base about the problem identified?
The gaps and conflicts in the knowledge base have been suitably identified, and it forms the aim and objectives of the research. Most studies reflected that pharmacological interventions as short-term therapy for treatment of insomnia, however, long term interventions are either unsuitable or relevant data are not available. Moreover, although non-pharmacological interventions for insomnia are endorsed, the usage patterns of such strategies are unknown. Thus, the research was conducted to document the effectiveness of such strategies on long-term basis and also the effectiveness of such strategies in individuals who cannot be treated with pharmacological interventions.
Does the literature review provide a sound basis for the study?
Yes, the literature provided a sound basis for the study. It highlighted the causative factors for insomnia and the adverse effects of insomnia on humans. The review further elucidated the present pharmacological and non-pharmacological currently available for the management of insomnia.
Theoretical/Conceptual Framework
Is there a clearly described theoretical/conceptual framework?
The theoretical and conceptual framework is clearly described because the research was conducted to address two specific issues. These were:
i. Evaluation of the used and perceived successful strategies, which alleviated insomnia.
ii. Evaluation of the correlation of alleviation strategies on age, gender, income and education.
The concept behind carrying such research stems from the fact that alleviation strategies whether pharmacological or non-pharmacological are not uniformly used and depends from individual to individual. This is because individuals may develop certain coping strategies that were not evaluated in earlier researches.
Protection of Human Research Participants
Explain what procedures were used to safeguard the rights of study participants.
The participants were interviewed, and data collection was done, on a none face-to-face basis, which helped to maintain the confidentiality and identity of an individual. Further, the study participants were reimbursed for the time they spent in undergoing the current research.
Are they sufficient?
Yes, the strategy of data protection and safeguarding the interests of participants were sufficient as there were no elements of induced bias or forceful inclusion of individuals in the study.
Research Design
Is the research study design clearly described? Is it appropriate for answering the research question?
The study design is appropriate since it involved randomized and intended to be a multi-centric trial (Polit & Beck, 2004). Hence, it is appropriate to answer the research questions based on responses from various populations.
• Does the study involve a treatment or intervention?
The study involved an evaluation of both treatment and intervention effectiveness through retrospective analysis.
• Is a research protocol clearly described and consistently implemented?
The research proposal was clearly described and had robust inclusion and exclusion criteria for sample selection.
Sample
• Was the population identified and described?
The study population included both males and females over the age of 18 years. The cut-off age was appropriate since insomnia is chiefly prevalent in adults compared to adolescents or children.
• Was the sample described in sufficient detail?
The sample was described in sufficient detail by age, gender, and sleeping habits along with pharmacological and non-pharmacological interventions used by them.
• Were sample biases minimized?
Sample biases were minimized through random selection of samples. However, samples were limited to Caucasians and women that may lead to involvement of elemental bias in the study.
• Was the sample size adequate? Was a power analysis reported?
The sample size was however not adequate since the Number Needed to Treat were not specified. Power analysis was also not reported, which can question the robustness and validity of the research findings (Polit & Beck, 2004).
Measurement
• Are instruments adequately described and are they appropriate choices given the study purpose, population, and variables being studied?
Yes, the instruments are adequately described since the research employed validated questionnaires, and further, the independent and dependent variables were distinctly specified.
• Is evidence of the instruments’ reliability and validity reported?
Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale are recognized instruments regarding reliability (Buysse et al., 1989). However, the validity of such scales about the study population could have been improvised.
Data Collection
Were the procedures for collecting data adequately described?
The process of data collection was adequately described, and it indicated that data was not generated as a wish of the respondents but was meticulously structured through paying participants for their involvement in the research and electronic documentation.
Was data collected in a manner that minimized bias?
The data collected had a minimal bias since the questions were reoriented in different ways to conclude a holistic notion on a specific question, specific intervention or a specific lifestyle. Further, data from drop-out individuals were excluded from the study. However, Caucasians and women were more in the study that could have lead to bias.
Data Analysis
• Were appropriate statistical methods used?
The statistical methods were appropriate as Pearson’s product moment correlation and Chi-square tests were used to evaluate the significance of various strategies and the correlation of such strategies with lifestyle variables (Polit & Beck, 2004).
Did the analysis control for confounding variables?
The analysis did provide control for confounding variables because the study incorporated various variables related to age, sex, and lifestyle habits.
Were Type I and Type II errors avoided or minimized?
Type 1 and Type II errors were not uniformly avoided as because standardization was not done for various age groups or race (Polit & Beck, 2004).
Findings
• Are all findings interpreted and discussed within the context of prior research and the theoretical/conceptual framework?
Yes, all findings were interpreted in the context of research questions as per level of significance selected for the study.
Are interpretations of findings well-founded and consistent with the study’s limitations?
The interpretations of findings were not conclusive because multiple combinations of strategies were undertaken by individuals either due to physician’s advice or self-interventions that may have created confounding effects.
How do the findings contribute to evidence-based nursing practice?
The recommendations based on this research may form a roadmap for healthcare providers. For example, it will help nursing personnel to implement appropriate intervention strategies for alleviating insomnia in their patients.
References
Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989).
“The Pittsburgh Sleep Quality Index (PSQI): A new instrument for psychiatric
research and practice.” Psychiatry Research, 28: 193–213.
Polit, D. F. & Beck, C.T. (2004). “Nursing Research: Principles and Methods.” (7th
ed.) Philadelphia, PA: Lippincott, Williams & Wilkins.
Riemann, D., & Perlis, M. (2009). “The treatments of chronic insomnia: A review of
benzodiazepine receptor agonists and psychological and behavioral therapies.”
Sleep Medicine Reviews, 13: 205–214
Reeve, K., & Bailes, B. (2010). “Insomnia in adults: Etiology and management.”
Journal for Nurse Practitioners, 6:53–60.

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