Translational Research and Evidence-Based Practice Essay

Translational Research and Evidence-Based Practice Essay

 

Literature Evaluation Table – DPI Intervention

Learner Name:

Instructions: Use this table to evaluate and record the literature gathered for your DPI Project. Refer to the assignment instructions for guidance on completing the various sections. Empirical research articles must be published within 5 years of your anticipated graduation date. Add or delete rows as needed.

PICOT-D Question:

 

Table 1: Primary Quantitative Research – Intervention (5 Articles)

APA Reference (Include the GCU permalink or working link used to access the article.)	Research Questions/ Hypothesis, and Purpose/Aim of Study	Type of Primary Research Design	Research Methodology ·         Setting/Sample (Type, country, number of participants in study) ·         Methods (instruments used; state if instruments can be used in the DPI project) ·         How was the data collected?	Interpretation of Data (State p-value: acceptable range is p= 0.000 – p= 0.05)	Outcomes/ Key Findings (Succinctly states all study results applicable to the DPI Project.)	Limitations of Study and Biases	Recommendations for Future Research	Explanation of How the Article Supports Your Proposed Intervention
Gallegos, A. M., Heffner, K. L., Cerulli, C., Luck, P., McGuinness, S., & Pigeon, W. R. (2020). Effects of Mindfulness Training on Posttraumatic Stress Symptoms From a Community-Based Pilot Clinical Trial Among Survivors of Intimate Partner Violence. Psychological trauma: theory, research, practice and policy, 12(8), 859. https://doi.org/10.1037/tra0000975	The authors of this article aimed at assessing the feasibility and acceptability of an intervention developed for the clinical trial. The study also aimed at testing this psychophysiological model of MBSR effects on the outcomes of  PTSD, trauma-related, and trauma-exposed individuals’ symptomatology. The author hypothesized that a decrease in the severity of PTSD symptoms improved self-regulation capacity among MBSR participants as a result of this intervention.	This quantitative study adopted a two-arm, randomized pilot clinical trial design	The study involved women with 29 intimate partner violence (IPV) survivors 166 participants were approached but only 95 verbally consented. Unfortunately, out of this number, only 30 met consented to participation in the study. The study was conducted in New York, USA. Nineteen participants were randomly assigned to the MBSR intervention group while 10 were randomly assigned to the active control group. The intervention was a group-based eight-week MBSR intervention program that assessed PTSD symptoms, regulation of emotion, attentional function, and physiological stress. The control group received a health education manual. Life Events Checklist for DSM–5 [LEC-5) was used to assess participant eligibility while PTSD Symptoms Checklist (PCL-5) was used to assess outcomes pertinent to PTSD outcomes. This approach and tools would fit my DPI project. Data were collected at baseline, at eight weeks for posttreatment assessment, and at 12 weeks for postbaseline follow-up	p < .05 for PTSD symptom decreases; p < .01 for emotional dysregulation decrease within the groups Intergroup comparative difference statistics were significant	A decrease in PTSD symptoms and emotional dysregulation were observed in the intervention but not in the control groups The primary outcomes such as changes in dysregulation of emotion, physiological stress, and attentional function were not significant between groups	High attrition in the recruitment despite retention efforts led to a smaller sample size that limits the reliability of findings with a larger population and greater chances of type II errors. Lack of double-blinding due to resource limitation could have led to an experimenter bias in this study	The authors recommended further studies to assess the effectiveness of model-guided interventions such as MBSR in PTSD treatment and stress regulation.	This study relates to my PICOT question almost in its entirety. The clinical problem, intervention, outcomes, comparison, and time have been addressed in this study. This study has provided insights into the assessment tools that could improve my DPI study.
Harding, K., Simpson, T., & Kearney, D. J. (2018). Reduced symptoms of post-traumatic stress disorder and irritable bowel syndrome following mindfulness-based stress reduction among veterans. Journal of Alternative and Complementary Medicine (New York, N.Y.), 24(12), 1159–1165. https://doi.org/10.1089/acm.2018.0135	This study aimed at examining the impact of MBSR on mindfulness skill building and the reduction of stress symptoms among veterans with PTSD and irritable bowel syndrome (IBS). The researcher hypothesized a reduction in these outcomes after treatment for patients who attended MBSR sessions.	Quantitative study with prospective cohort design and RCT designs	This study was a prospective study that involved 55 veterans with PTSD and IBS in VA Puget Sound Health Care System, Seattle, Washington. Veterans who had other mental health comorbidities such as bipolar disorder, and substance use disorders were excluded from this study. Participants were to attend nine MBSR sessions and were divided into three trials. The first trial group represented participants who were through a prospective cohort study using MVSR as an intervention but the second and third trial groups participated in randomized control trial studies that used usual care as control.  The 17-item PTSD Checklist was used to assess PTSD symptoms while the 4-item Irritable Bowel Severity Scoring System (IBS-SSS) was used to assess the IBS symptoms severity at baseline and the study end.	McNemar’s test showed a reduction of PTSD severity at 4 months post-MBSR p=0.008 and IBS symptoms severity at 4 months post-MBSR (p < 0.001)	Veterans at 4 months post-MBSR reported symptom severity reduction in PTSD and IBS. The reduction in IBS-related symptoms was statistically insignificant. Before treatment, participants had 100& comorbidity but after treatment, only 77.50% met the criteria for PTSD diagnosis.	There was room for influence from confounding factors in that group’s social support, behavioral activation could have impacted the self-reported outcomes	The researchers recommended MBSR as a promising transdiagnostic intervention in the treatment of trauma-related psychological outcomes with related comorbidities such as IBS and depression. Further studies are still required to understand these comorbidities.	The intervention in this study is similar to my proposed intervention. Its prospective utilization and preservation to the control group would allow for comparison in my study
Davis, L. L., Whetsell, C., Hamner, M. B., Carmody, J., Rothbaum, B. O., Allen, R. S., Al Bartolucci, A. B. P. P., Southwick, S. M., & Bremner, J. D. (2019). A multisite randomized controlled trial of mindfulness-based stress reduction in the treatment of posttraumatic stress disorder. Psychiatric Research and Clinical Practice, 1(2), 39–48. https://doi.org/10.1176/appi.prcp.20180002	This study aimed at examining the efficacy of MBSR in PTSD treatment among US veterans. The researchers hypothesized that MBSR would improve PTSD symptoms compared with present-centered group therapy (PCGT) after nine weeks of follow-up.	A quantitative method study that adopted a multisite, single-blind, randomized control trial designs	A total of 214 veterans diagnosed with PTSD in VA Medical Centers located in the southeastern United States were randomly assigned to intervention (95) and control groups (95). Before this random assignment, veterans with bipolar disorder, schizophrenia, substance use, and schizoaffective disorder were excluded. The intervention groups received weekly 90-minute MBSR sessions while the control groups received weekly 90-minute present-centered group therapy (PCGT) sessions. PTSD Checklist—Self-Report (PCL), the Five Facet Mindfulness Questionnaire–Self-Report (FFMQ), and the nine-item self-report Patient Health Questionnaire were used to assess and evaluate PTSD symptoms, mindful living, and depression respectively at bassline, third week, sixth week, and at endpoint (9th week). The ninth-week assessment only included 142 participants as opposed to 254 who initially consented to the study and 214 who were eligible and assigned to study groups.	Rates of remission between intervention and control groups were 30.7% and 27.3% respectively with p-value p=0.662	Improvement in primary outcomes was observed in both intervention and control groups. However, these differences were not statistically significant apart from differences in PCL-5 scores.	The study had high attrition rates that limited the generation of findings. The study participants were not gender balanced with only 31 of214 participants	The researcher recommended that MBSR should be used to supplement but not replace preexisting psychotherapeutic therapies for PTSD patients.	This study compares my intervention to another psychotherapeutic modality for PTSD patients. the article supports the use of my intervention PTSD treatment with evidence gaps in its superiority in practice
Simshäuser, K., Lüking, M., Kaube, H., Schultz, C., & Schmidt, S. (2020). Is mindfulness-based stress reduction a promising and feasible intervention for patients suffering from migraine? A randomized controlled pilot trial. Complementary Medicine Research, 27(1), 19–30. https://doi.org/10.1159/000501425	This study aimed at examining the feasibility and effect sizes of MBSR on a sample migraine patient. The researchers hypothesized that migraine is a condition sensitive to stress is fit to respond to MBSR which aims at stress reduction.	This quantitative study adopted a randomized clinical trial design	This study randomly assigned a total of 62 migraine patients from a population of 214 patient who was interested in the study with 93 participants meeting the eligibility criteria for intervention and control groups but 18 were lost to follow-up (6 from intervention and 12 from the control group). Only 50 participants were available for post-measurements (26 for intervention and 24 in control groups). The study was carried out in Freiburg Germany with participants sourced from the internet advertising and Interdisciplinary Pain Center of the University Medical Center. The intervention group received a weekly 2.5-hour MBSR session. The control groups received an active control intervention based on progressive muscle relaxation and psychoeducation. Primary outcomes assessed migraine frequency per month while secondary outcomes include functional impairments, psychological symptoms, life quality, and self-attributed mindfulness among other measurements.  Assessments were carried out at baseline, posttreatment (8 weeks), and follow-up (twelve months). Phycological tools were a brief symptom inventory and Freiburg Mindfulness Inventory that I will consider in my DPI	Anxiety reduction in the intervention  higher than control group (F(1, 40) = 9.69, p < 0.01) but no significant improvements in mindfulness (p=0.37) and depression (p=0.50)	Greater improvements were reported in the MBSR group in psychological symptoms. More adaptive and coping strategies improvement were realized in the intervention group.	High attrition rates limited the generalizability of the results.	The researcher recommended carrying out larger RCT studies to evaluate the effectiveness of psychological and non-psychological outcome improvements	The study asserted the applicability of my intervention in nonpsychiatric settings and patient care. Including measurements of phycological symptoms such as headaches and physiological outcomes of anxiety will be important.
Dumarkaite, A., Truskauskaite-Kuneviciene, I., Andersson, G., & Kazlauskas, E. (2022). The effects of an online mindfulness-based intervention on posttraumatic stress disorder and complex posttraumatic stress disorder symptoms: A randomized controlled trial with 3-month follow-up. Frontiers in Psychiatry, 13, 799259. https://doi.org/10.3389/fpsyt.2022.799259	This study aimed to assess the efficacy of an online mindfulness-based intervention on PTSD and complex PTSD symptoms after treatment and after three months of follow-up. The study hypothesized that online mindfulness-based strategies can improve PTSD and CPTSD	This study was a randomized controlled design study	This RCT had pre-intervention (baseline), postintervention (8 weeks), and 3-month follow-up measurement points, and involved 53 young adults in Lithuania who had encountered trauma and had trauma-related psychological symptoms. These participants were randomly assigned to intervention 17, and control group 36. This difference was because 23 participants were lost to follow-up in the intervention group. International Trauma Questionnaire (ITQ) tool was used to assess outcomes in this study. This instrument is usable in my DPI.	PTSD scores and disturbance in self-organization scores were lower in the intervention group p = 0.016. Between-group PTSD effects were non-significant	Mindfulness-based interventions improved PTSD symptoms, feelings of negative concepts, disturbances in self-organizations	High attrition rates in the intervention groups limited the comparison of findings and generalizability of the study outcomes. Self-reporting of outcomes over the internet could lead to under- or overestimation of outcomes.	Mindfulness-based strategies can be applied to PTSD and self-organization in cases where regulation of self-capacity is required	This study provides insight into a new method of delivering my intervention. The use of the internet is an explorable option for intervention delivery but with its own limitations

 

 

Table 2: Additional Primary and Secondary Quantitative Research (10 Articles)

APA Reference (Include the GCU permalink or working link used to access the article.)	Research Questions/ Hypothesis, and Purpose/Aim of Study	Type of Primary or Secondary Research Design	Research Methodology ·         Setting/Sample (Type, country, number of participants in study) ·         Methods (instruments used; state if instruments can be used in the DPI project) ·         How was the data collected?	Interpretation of Data (State p-value: acceptable range is p= 0.000 – p= 0.05)	Outcomes/ Key Findings (Succinctly states all study results applicable to the DPI Project.)	Limitations of Study and Biases	Recommendations for Future Research	Explanation of How the Article Supports Your Proposed DPI Project
Hilton, L., Maher, A. R., Colaiaco, B., Apaydin, E., Sorbero, M. E., Booth, M., Shanman, R. M., & Hempel, S. (2017). Meditation for posttraumatic stress: Systematic review and meta-analysis. Psychological Trauma: Theory, Research, Practice, and Policy, 9(4), 453–460. https://doi.org/10.1037/tra0000180	The study’s research question stated, “What are the effects of meditation interventions on PTSD symptoms, depression, anxiety, health-related quality of life, functional status, and adverse events compared with treatment as usual (TAU), waitlists, no treatment, or other active treatments, in adults diagnosed with PTSD?” This study aimed at synthesizing randomized controlled trials to provide data on the safety and efficacy of meditation interventions in PTSD treatment	This study used a quantitative method that adopted a systematic provide design with a metanalysis of randomized controlled trials. Therefore, it is secondary quantitative research	The study included 10 RCTs where eight were conducted in the United States while the other two were conducted in the middle east. These studies yielded a total of 643 participants. Research literature items were sourced using PRISMA guidelines. Quality of evidence was appraised using the Grade of Recommendations Assessment, Development, and Evaluation (GRADE) approach and outcomes of interest extracted from these sources using the Hartung-Knapp-Sidik-Jonkman method for random-effects models. These approaches would not fit my DPI methodology	Yoga is not superior to MBSR in PTSD symptoms reduction(p= .76) The Mantram repetition program is not superior to MBSR in PTSD symptoms (p= .84)	Mindfulness-based stress reduction strategies were analyzed for outcomes using meta-regression. This analysis showed that the comparators, yoga, and Mantram repetition programs, did not significantly affect PTSD symptoms more than MBSR	Some studies lacked participant blinding which could result in detection and performance biases. Half of the analyses studies were rated poor in terms of evidence quality	The authors recommended MBSR use in PTSD  and depression management. However, confidence in these findings was not guaranteed, and as such, higher-quality studies are still required on this topic to provide high-level and reliable evidence	The study compares my intervention, MBSR, to other related interventions such as the Mantram repetition program and yoga. The outcome comparisons in this article are not limited to PTSD outcomes but also include depression, other anxiety, and patient functional status.
Juul, L., Pallesen, K. J., Bjerggaard, M., Nielsen, C., & Fjorback, L. O. (2020). A pilot randomized trial comparing a mindfulness-based stress reduction course, a locally-developed stress reduction intervention, and a waiting list control group in a real-life municipal health care setting. BMC Public Health, 20(1), 409. https://doi.org/10.1186/s12889-020-08470-6	This study aimed to compare the effectiveness of MBSR and a waiting list control group in stress reduction. The researcher developed a locally-developed stress reduction intervention (LSR) which is an MBSR for stress reduction in a Danish municipal health care center setting.	This study was a three-armed parallel pilot RCT	The researcher randomized 71 adults from the Municipality of Aarhus in Denmark who had contacted the health center with stress-related complaints into MBSR (24), LSR (23), and the waiting list group (24). The LSR group received a non-curriculum-based MBSR developed by local psychologists. This LSR emphasized more on cognitive-based and psychoeducational approaches, while the other components were similar to MBSR. Assessment tools used included the perceived stress scale (PSS), the Hopkins symptom check List-5 (SCL-5), the WHO-5-wellbeing scale (WHO-5), the brief resilience scale (BRS), the Amsterdam resting state questionnaire (ARSQ), the self-compassion scale (SCS), and the experiences questionnaire (EQ). data was collected at the preintervention and 12th-week follow-up stages.	The researchers analyzed the comparative superiority of the three interventions and no null hypothesis significance testing in p-value form was presented.	Comparative questionnaire completion percentage showed that MBSR was still superior to the locally developed form, LSR.	A lack of blinding would have caused an experimenter bias. The study only assessed completion rates and choices by participants but not the actual psychological outcomes of the participants	This was a pilot RCT that recommended further studies to carry out more research on the effectiveness of LSR and MBSR	This article presented a modified version of my intervention to meet the needs of local practice. The findings can be used to develop my intervention for the DPI project that will strive to avoid the documented challenges and achieve the successes the LSR achieved in this study
Hou, Y., Zhao, X., Lu, M., Lei, X., Wu, Q., & Wang, X. (2019). Brief, one-on-one, telephone-adapted mindfulness-based stress reduction for patients undergoing percutaneous coronary intervention: a randomized controlled trial. Translational Behavioral Medicine, 9(6), 1216–1223. https://doi.org/10.1093/tbm/ibz130	The study aimed at examining the effectiveness of a brief one-on-one telephone-based MBSR among percutaneous coronary intervention (PCI) patients in the short term. The researchers hypothesized that the developed MBSR that included one-on-one, brief, and telephone-based strategies would improve the psychological symptoms of PCI patients.	This study was a quantitative method study that adopted a randomized controlled trial	This RCT randomized 70 PCI patients from a cardiology division of a university hospital in Suzhou, China into intervention (35) and waiting list groups (35) patients. The researchers assessed depression, stress, and mindfulness using the Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS), and short form of the Freiburg Mindfulness Inventory (FMI-s) at baseline and after the 6th week. These tools apply to my DPI. The attrition rate was 11%	MBSR improved HADS (p = .006) and PSS (p = .035) as compared with the waiting list group	The psychological distress among PCI patients was better reduced by implementing MBSR. The ease of implementation, shorter implementation period, and user-friendliness were some of the features of this program that facilitated its success	The smaller sample size (70) and lack of active control limited the generalizability of the findings of this study	The researchers recommended using this version of modified MBSR among patients older than 70 years to decrease psychological distress.	This article evaluated my intervention in terms of its user-friendliness, and usability, defining the duration of intervention and factoring in the concept of age of participants in the acceptability and intervention feasibility.

 

 

 

Table 3: Theoretical Framework Aligning to DPI Project

Nursing Theory Selected	APA Reference – Seminal Research References (Include the GCU permalink or working link used to access each article.)	The explanation for the Nursing Theory Guides the Practice Aspect of the DPI Project
Self-efficacy theory in nursing practice	Shorey, S., & Lopez, V. (2021). Self-efficacy in a nursing context. In Health Promotion in Health Care – Vital Theories and Research (pp. 145–158). Springer International Publishing. https://doi.org/10.1007/978-3-030-63135-2_12	Shorey & Lopez (2021) explained the application of self-efficacy as a key predictor in self-management and behavior change thus the need to shift to health-centered mechanisms. In this project focusing on the outcomes of PTSD rather than the cause of PTSD would guide the implementation of MBSR interventions chosen to achieve outcomes. Regardless of the traumatic nature of the cause of trauma, PTSD symptoms will be key stepping stones to kickstarting the implementation and baseline for assessing outcomes.
Change Theory Selected	APA Reference – Seminal Research References (Include the GCU permalink or working link used to access each article.)	The explanation for How the Change Theory Outlines the Strategies for Implementing the Proposed Intervention
Self-regulation model in Gallegos et al. (2020)	Gallegos, A. M., Heffner, K. L., Cerulli, C., Luck, P., McGuinness, S., & Pigeon, W. R. (2020). Effects of mindfulness training on posttraumatic stress symptoms from a community-based pilot clinical trial among survivors of intimate partner violence. Psychological Trauma: Theory, Research, Practice and Policy, 12(8), 859–868. https://doi.org/10.1037/tra0000975	Gallegos et al. (2020) explained a self-regulation model where mindfulness-based stress reduction through non-trauma-focused interventions can enhance self-regulation of emotion, cognition, and attention. This framework can enable the implementation of my DPI intervention by focusing on psychotherapeutic intervention including psychoeducation aimed at inhibiting symptoms rather than emphasizing the traumatic events. Focusing on improving memory, attention, and mood can be the basis of change in achieving clinical outcomes

 

 

Table 4: Clinical Practice Guidelines (If applicable to your project/practice)

APA Reference – Clinical Guideline (Include the GCU permalink or working link used to access the article.)	APA Reference – Original Research (All) (Include the GCU permalink or working link used to access the article.)	The explanation for How Clinical Practice Guidelines Align to DPI Project
Guidelines used in Hilton et al. (2017) study	Hilton, L., Maher, A. R., Colaiaco, B., Apaydin, E., Sorbero, M. E., Booth, M., Shanman, R. M., & Hempel, S. (2017). Meditation for posttraumatic stress: Systematic review and meta-analysis. Psychological Trauma: Theory, Research, Practice and Policy, 9(4), 453–460. https://doi.org/10.1037/tra0000180	Hilton et al. (2017) guidelines provided clinical guidelines on MBSR implementation from previous randomized clinical trials. A typical MBSR intervention implementation runs for 8 weeks.  Assessment of quality of life, and patient functional status alongside PTSD symptoms is essential. In research, larger sample size studies are still required to ascertain the quality of evidence on the superiority of MBSR to other strategies.

 

The purpose of this two-part assignment is to identify a minimum of 15 empirical research articles that support the intervention for your proposed DPI Project. In this topic, you will complete Part I by identifying eight of the 15 articles.
Using the \”Levels of Evidence in Research\” document, located in the Class Resources, identify eight empirical research articles to support the proposed intervention for your DPI Project. Complete the following steps using the attached \”Literature Evaluation Table – DPI Intervention\” document:
1. Present your PICOT-D question.
2. Table 1: Identify five primary quantitative research articles that support your intervention. Two of the articles must come from the United States or Canada. Three additional articles may come from any of the following countries: United Kingdom, Denmark, India, New Zealand, Germany, or Australia.
3. Table 2: Identify three primary or secondary quantitative research studies that provide additional support for your intervention or some aspect of your intervention. These four articles may come from any of the 133 countries listed on the \”International Compilation of Human Research Standards,\” located in the Class Resources.
4. Table 3: Present the nursing and change theory that align to the DPI Project (from DNP-815A).
5. Table 4: Present the clinical guidelines that align to the DPI Project, if applicable. If you choose to implement a clinical practice guideline, include the primary research for the clinical practice guideline as part the primary quantitative research that supports your intervention (Table 1)
6. Refer to the \”Levels of Evidence in Research\” resource, located in the Class Resources.