Task 1 -XAP1: Evidence Based Practice and Applied Nursing Research

Evidence-Based Practice and Applied Nursing Research

Task 1 -XAP1

05/08/20

Western Governors University

Quantitative Article 

     Reduced strength, poor balance, and concern about falls mediate the relationship between knee pain and fall risk in older people. (Hicks et al. 2020).

Background or Introduction

The study aimed at pain as one significant causes of fall risk and is subjective from an individual point of view. The research also emphasizes experimentally that people, especially the older adults with musculoskeletal knee pain, display unstable coordination and are prone to falls, agreeing to a widespread of chronic pain among older people ranging between 25- 76% (Hicks et al. 2020).

Review of the Literature

The researchers cited 40 articles relating to pain, increasing the risk of falls in older populations. A couple of the topics the researchers used to support their study include first, an article examining a wide range of physical, phycological, and medical factors related to knee pain and falls. The other research also explained that people with knee pain would experience decreased coordination and balance compare to people that have no pain. As research, this type of pain leads to increase fear, depression, anxiety, and need for more medications among the elderly. (Hicks et al. 2020).

Data Analysis

The researchers statistically analyzed their data using a right-skilled division squared rooted. Chi-square test was applied when collating the comprehensive data of falls derived due to pain in the study compared with the group that’s without pain. The Modified Poisson Regression was used to ascertain the Related-Risk (RR) connected to the group with many falls due to knee pain. Generally, SPSS model 25 and SPSS science statistically utilized to do the whole analysis (Hicks et al.  2020).

Discussion of Methodology

The researchers applied a quantitative randomized control method in the study. The participants were 176 women and 157 men and altogether 300 in number. These individuals are people who agreeably volunteered to register into a broad longitudinal research group for cognitive and aging study and followed up for a year. These men and women live in a particular community in the eastern part of Sydney. 

People involved in the research got handpicked. Anyone with a graded Mini-Mental State Examination lower than twenty-four, or with no adequate understanding of English, history of mental or neurological diseases and or a diagnosis that could hinder them, were rejected from participating. Also, the researchers required a yes or no response to interrogations. For example, they had queries like, recently, have you suffered any kind of sickness related to leg or knee pain? (Hicks et al. 2020).

Quantitative: Conclusions

     In general, the conclusion of the study showed that falls were associated with many prescribed drugs for the treatment of mental or neurological and musculoskeletal pain, especially related to the knee. The research observed the pain of the knee contributes to twice the risk of many falls among the elderly population. Therefore, reducing pain in the knee and managing the cause that results in fall-risks are aids that can stop falls incidents among older individuals suffering from knee pain (Hicks et al. 2020).

       In the introductory background, the conclusion unveiled that reports acute pain in the knee, including one other area that is important to the body, can cause more chances to fall. The reviewed literature concludes research that the group of individuals with knee pain showed a more notable high rate of falls that is in-line with an introductory study of the individuals suffering pain in some part of the body and or those with others bone-arthritis. Data analysis conclusion showed that the people involved in the trial that are unable to meet the health assessment requirements got a lower or higher grade using a standard-3 deviation that portrays how they performed in the observation. While the conclusion of research methodology was on how the people got involved were selected by asking them a yes or no with a question about their health (Hicks et al. 2020).

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Quantitative: Protection and Considerations

      For protection and consideration purposes, volunteers in the research were to provide a consent form to become a part of the study and to have their information made commercial. The research got confirmed by the University of New South Wales Human Ethics Study Protocol Committee (Hicks et al. 2020).

Quantitative: Strengths and Limitation 

        A strength observed in this study was that it is a large randomized sample size. The reason for this is that a total of 333 people was involved got selected based on projected and necessary observations around a medical diagnosis of mental and physical and mobility-wise measures that leads to falls. While the limitation was that most of the projected contemplation of falls were unable to define fall and there was no quantitative physical way of calculation to note the risks that led to a fall (Hicks et al. 2020).

Quantitative: Evidence Application

  As a nurse, I now understand from this study that a substantial number of older adults with more especially knee pain are prone to fall-risk. Therefore, when I have an opportunity to care for these elderly populations, I will be considerate to ask and know if they have any musculoskeletal pain. Also, their health condition, physical observation, medications, and together, their concern for knee pain are all triggering factors that will enable me to care for them with the mind of preventing fall-risk. 

Qualitative Research Article

 Exploration of older people’s perceptions of behavioral factors associated with falls. (Robson, K., Coyle, J., & Pope, R. 2018).

Background or Introduction

Issues about falling rates amongst older individuals continue to take a peek-rise even though, and there are strategic plans put in place to mitigate the risk of falls. The fact is that a way to promote the decrease of falls among the elderlies is to acknowledge first what their thought is about the risk of falling. Therefore, this research study is looking at the views and attitudes surrounding older people's conclusions about fall risk. Also, many types of research had proven that the older people's ideas about risk do show that they sometimes do not want to accept the fact that their risk of falling exposes them to unexpected injuries (Robson et al. 2018).

Review of the Literature

This researcher cited Seventeen other researched study. One of the articles the researcher cited deliberated more on why older people develop a misconception that the risk of falls is a mystery. Researchers are concerned that not much could explain the reasons why older people come up with that conclusion that leads to their risk of falls, other than the widespread believe that they being old are not at risk. The second article cited was a study that revealed that most injuries connected to falls in older adults create a place of significance when it comes to public health (Robson et al. 2018). 

Data Analysis

The researchers analyzed the data using short and a simply well-explained participant’s information that is supported with hermeneutics to present their results. Researchers applied this point of view critically in both to either recognize or to illustrate themes found in the study.

  Discussion of Methodology

The researchers used a qualitative method to apply a hermeneutic perspective while interviewing elderly individuals on their experiences concerning the times they had falling. The hermeneutics process needed enabled researchers to realize before-hand the facts of what they are about to study, which has to do with fall risk, so this helps to enlighten their understanding about what those participating in the study is explaining to the researcher in a better way. These procedures are "fusion of horizon" (Robison et al. 2018).

Qualitative: Conclusions

The conclusion was on qualitative findings that critically look whether older people have to fall in the past or present, understand what reasons led to them falling, and what basic understanding they have learned from indulging in actions that could lead to fall-risk. Hence, the researchers focused mainly on the compound effects between older individuals who need their freedom to make a decision, and other factors may present or lessens their risks for falls (Robison et al. 2018). 

 So, the introduction looked at the different aspects surrounding how older people manage fall risk, how it impacts their attitudes, becomes an integral part of the progress they have in lowering their rate of falls. Then in the review literature, the conclusion of one among the articles the researchers reviewed proved that the connections between the way older individuals' reason over fall-risk do not show they understand it could lead to injuries (Robison et al. 2018).

Data analysis conclusion includes the need to make sure the research entails a variety of honest methodical ways decided on collating information and analysis that can be relied on and understood. With the agreement of hermeneutics, the study used a far-more understandably parts of information from those who participate to show the result. At the same time, the Methodology conclusion states that hermeneutics procedures would expect that the researchers establish a pre-causal understanding leading to the issue of fall-risk (Robison et al. 2018).

Qualitative: Protection and Considerations 

Protection and considerations through the ethics committee showed that ethical approval obtained was via the appropriate committee. Those who participated in the study were to provide a signed consent form before participation. The participants got informed that their involvement was voluntary. Their identities were replaced with a fictitious name to adequately protect their details (Robison et al. 2018).

 Qualitative: Strengths and Limitations

This qualitative study’s strength is weak but organized. The researchers collated and analyzed the study in such a way that it could be understood. For example, the researchers explored the attitude surrounding the older adult's view about fall-risk by taking on a project. The limitation was that researchers worked with a small sample of individuals from a geographical area in Australia (Robison et al. 2018).  

Qualitative: Evidence Application

 To conclude, an evidence application of this article, help me as a nurse working in the hospital to be informed about how older adults required my care reason over fall-risks. Therefore, to apply this subject, it is my job to give them a reorientation about themselves and their environment continually. As a nurse caring for older people that get admitted into the hospital because they fell, I must educate them. I will ask the physician for an order of physical therapy to assist them in understanding that their ways of reasoning could be right, but they as a human could also misjudge things around them sometimes. So, they always need to take precaution and ask for help if they are not acquainted with any environment.

References

Robson, K., Coyle, J., & Pope, R. (2018). Exploration of older people’s perceptions of behavioural factors associated with falls. Age and Ageing, 47(5), 734–740. https://doi.org/10.1093/ageing/afy051

Hicks, C., Levinger, P., Menant, J. C., Lord, S. R., Sachdev, P. S., Brodaty, H., & Sturnieks, D. L. (2020). Reduced strength, poor balance and concern about falls mediate the relationship between knee pain and fall risk in older people. BMC Geriatrics, 20(1), 94. https://doi.org/10.1186/s12877-020-1487-2