400863 Foundations Of Research And Evidence Based Practice

Question Describe the background and reasons for evidence-based practice and health research. Design and perform an advanced search strategy for a PIC. Identify types and levels of evidence within the healthcare research continuum. Describe the ethical responsibilities for EBP and health research. Explain how data may be described and summarised in health research. Describe the core statistical concepts used to provide meaning from health research data7Integrate evidence into academic writing. Answer Using Evidence The PICO framework was selected for formulating the research question, in relation to the phenomenon being investigated. The research terms that corresponded to each element of the PICO framework are given below: P (Population) Aged patients with chronic low back pain I (Intervention) Acupuncture C (Comparison) Standard care O (Outcome) Better health outcomes and reduced pain Table 1- PICO Framework This was followed by input of key phrases and search terms in the electronic database of CINAHL that were combined with the boolean operator ‘AND’. The articles were limited to those that were peer reviewed and published in English language, on or after 2013, and containing information on elderly people (+65 years as the target population). This helped in final retrieval of three articles that are supported by the search history images provided below: Figure 1- Search history Figure 2- Search history The three sources of evidence that were extracted at the end of the results are given below: Weiß, J., Quante, S., Xue, F., Muche, R., & Reuss-Borst, M. (2013). Effectiveness and acceptance of acupuncture in patients with chronic low back pain: results of a prospective, randomized, controlled trial. The Journal of Alternative and Complementary Medicine, 19(12), 935-941. Shin, J. Y., Ku, B., Kim, J. U., Lee, Y. J., Kang, J. H., Heo, H., … & Lee, J. H. (2015). Short-Term effect of laser acupuncture on lower back pain: A Randomized, Placebo-Controlled, Double-Blind Trial. Evidence-Based Complementary and Alternative Medicine, 2015. Bahrami-Taghanaki, H., Liu, Y., Azizi, H., Khoursand-Vakilzadeh, A., Esmaily, H., Bahrami, A., & Zhao, B. X. (2014). A randomized controlled trial of acupuncture for chronic low back pain. The Journal of Alternative and Complementary Medicine, 20(5), A40-A40. Section 1 The three articles were finally extracted after the application of filters and limiters and selected best evidence for the scenario 3 owing to the fact that all three were randomised controlled trials that refers to a scientific experiment that is usually conducted with the aim of lowering risks of bias, while testing the efficacy of a new intervention. Moreover, RCTs have been considered best scientific evidence and are arranged in the highest rank (level I) (Barton et al., 2015). Thus, using results obtained from the RCTs will facilitate determination of the strength of the results that are presented by the authors. All three are also valid and reliable since little time has passed since they were generated. Owing to the fact that all three articles investigated the impacts of different types of acupuncture for the management of chronic low back pain, which was the phenomenon of investigation of scenario 3, they were considered best for this research question. Section 2 Introduction- Low back pain (LBP) refers to a common disease that involves the nerves, bones, and muscles present in the back and vary from sudden sharp ache to dull feelings. LBP is usually classified as acute or chronic depending on the time they last in a person. While those lasting for less than 6 weeks are acute, chronic LBP usually last for more than 12 weeks among the affected people (Goodman, Burke & Livingston, 2013). Recent researchers have placed due attention on acupuncture as an alternative therapy for the treatment of chronic LBP, even citing it more effective than medications (Lam, Galvin & Curry, 2013). Hence, this essay will discuss findings from three scholarly articles that explore the effects of acupuncture on LBP treatment. Discussion- Weiß et al. (2013) stated that upon randomly assigning LBP patients to two groups, those who were subjected to acupuncture sessions twice weekly demonstrated meaningfully healthier physical functioning, vitality, general health, and expressive role, in comparison to patients in group B (control). Pain outcomes were also superior in group A, compared to patients in group B, thus establishing the acceptability and effectiveness of acupuncture in management of chronic LBP. According to Shin et al. (2015) when patients in case group were subjected to laser acupuncture, in comparison to the controls subjected to sham laser acupuncture, no significant differences were observed between them. However, members in both groups showed a noteworthy enhancement in each measured parameter, relative to the starting point values. Hence, the authors were not able to establish laser acupuncture as an effective treatment for LBP. In the RCT conducted by Bahrami-Taghanaki et al. (2014) Chinese men and women suffering from chronic LBP were subjected to treatment that trailed RA protocol, besides acupuncture related to time (TA) in the case group. They stated that there was a decrease in visual analogue scale (VAS) scores from 69.6 ± 7.9 to 11.8 ± 4.9 in the case group, when compared to the controls. In other words, the first and the third articles are superior in their evidences that can be applied in real time settings, since the second article failed to explore and confirm the efficacy of the intervention (acupuncture) on health of LBP patients. Hence, it can be stated that subjecting patients who are diagnosed with chronic LBP to acupuncture therapies that are conducted at least twice or thrice, per week will prove as an effective strategy in management of the chronic condition, thus providing pain relief. Conclusion- Thus, it can be concluded that the strength of the first and third evidences are maximum, in comparison to the second scholarly article discussed in the previous section. Hence, normal acupuncture or laser acupuncture therapy can be implemented while treating LBP patients. However, further research needs to be conducted on bee venom acupuncture, before it is used as an intervention in such cases. References Bahrami-Taghanaki, H., Liu, Y., Azizi, H., Khoursand-Vakilzadeh, A., Esmaily, H., Bahrami, A., & Zhao, B. X. (2014). A randomized controlled trial of acupuncture for chronic low back pain. The Journal of Alternative and Complementary Medicine, 20(5), A40-A40. Barton, C. J., Lack, S., Hemmings, S., Tufail, S., & Morrissey, D. (2015). The ‘Best Practice Guide to Conservative Management of Patellofemoral Pain’: incorporating level 1 evidence with expert clinical reasoning. Br J Sports Med, 49(14), 923-934. Goodman, D. M., Burke, A. E., & Livingston, E. H. (2013). Low back pain. Jama, 309(16), 1738-1738. Lam, M., Galvin, R., & Curry, P. (2013). Effectiveness of acupuncture for nonspecific chronic low back pain: a systematic review and meta-analysis. Spine, 38(24), 2124-2138. Shin, J. Y., Ku, B., Kim, J. U., Lee, Y. J., Kang, J. H., Heo, H., … & Lee, J. H. (2015). Short-Term effect of laser acupuncture on lower back pain: A Randomized, Placebo-Controlled, Double-Blind Trial. Evidence-Based Complementary and Alternative Medicine, 2015. Weiß, J., Quante, S., Xue, F., Muche, R., & Reuss-Borst, M. (2013). Effectiveness and acceptance of acupuncture in patients with chronic low back pain: results of a prospective, randomized, controlled trial. The Journal of Alternative and Complementary Medicine, 19(12), 935-941.

400863 Foundations Of Research And Evidence Based Practice

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