NUR 705 Assignment 2.1: Systematic Article Review—Part I

NUR 705 Assignment 2.1: Systematic Article Review—Part I

Value: 5 points


In this course, you will conduct several article critiques on articles related to your potential DNP project topic. This week, you will orient yourself with the topics of literature that you need to review for your DNP project. You should take into consideration variables, populations, and levels of evidence. You will locate an article and submit the article for consideration this week. Your critique of the article will be due in Week 4.

To help you prepare to critique the article, watch the Nursing Research—How to Critique an Article video.

Assignment Guidelines

  1. Complete the National Library of Medicine’s training on Using PubMed in Evidence-Based Practice (Links to an external site.).
  2. Search the library for a systematic review research article that is related to your DNP project.
  3. Select one systematic review research article that you will use for your first article review.
  4. Submit the link or a PDF copy of your article and your justification for the selected article. Your justification should include:
    • A summary of how the article relates to your potential DNP project topic.
    • The search terms you used in your search.
    • The filters that you established for your search, such as year limits.
    • The process you used to review the search results.


Submit your assignment and review full grading criteria on the Assignment 2.1: Systematic Article Review—Part I page.

Conducting Research

Review the Introduction to Nursing Research Guides video from the Bradley Library to learn how to begin your search for articles.

Introduction to Nursing Research Guides Transcript (Links to an external site.)

Search StrategiesReview the Building a Search Strategy video from the Bradley Library to learn about developing a strategy when searching for articles for your DNP project.

Building a Search Strategy Transcript (Links to an external site.)

How to Construct a Search StrategyReview the media on how to construct a search strategy.

How to Construct a Search Strategy thumbnail image

Week 2: Literature Reviews: Integrative, Systematic, and Meta-Analysis

Lesson 1: Literature Reviews: Integrative, Systematic, and Meta-Analysis


Using research findings in practice begins with reviewing the literature. In this lesson, you will learn about the types of literature reviews and how they can be used as a starting point for evidence evaluation. You will learn how to conduct a search strategy to optimize your findings.

Learning Outcomes

At the end of this lesson, you will be able to:

  • Distinguish the differences between levels of evidence in the literature.
  • Analyze DNP project ideas and access the information needed to complete the research.
  • Identify key components within a literature review that need to be evaluated.
  • Conduct a literature review on a topic related to the DNP project.

Before attempting to complete your learning activities for this week, review the following learning materials:

Learning Materials

Read the following in your Polit & Beck (2021) Nursing research: Generating and assessing evidence for nursing practice textbook:

  • Chapter 2, “Evidence-Based Nursing: Translating Research Evidence into Practice” pages 21–28 (stop at “Evidence Hierarchies and Level of Evidence Scales”)
  • Chapter 5, “Literature Reviews: Finding and Critically Appraising Evidence”
Article Review—Part I Rubric
Appropriate Selection of Research Article
1 pts
Meets Expectations

An appropriate research article is selected for the article critique.

0 pts
Does Not Meet Expectations

No article is selected, or an inappropriate article is selected for the article review.

1 / 1 pts
Justification of Article Selection
2 pts
Meets Expectations

Justification includes an adequate summary of how the article relates to the DNP project. Justification includes search terms, filters, and the process used for the article search.

1 pts
Nearly Meets Expectations

Justification includes a summary of how the article relates to the DNP project. Justification does not include search terms, filters, and the process used for the article search.

0 pts
Does Not Meet Expectations

Justification does not include a summary of how the article relates to the DNP project. Justification does not includes search terms, filters, and the process used for the article search.

2 / 2 pts
Documentation and Mechanics
2 pts
Meets Expectations

No errors in grammar, spelling, punctuation, or sentence structure.

1 pts
Nearly Meets Expectations

Few errors in grammar, spelling, punctuation, or sentence structure.

0 pts
Does Not Meet Expectations

Numerous and distracting errors in grammar, spelling, punctuation, or sentence structure.

2 / 2 pts
Total Points: 5

Nursing Research—How to Critique an Article Transcript

In this video, what we’re going to do is we’re going to show you how to do a research critique. Now, a lot of people tell me that the critique takes them six to eight hours, and the work that they produce out of that six to eight hours is so ridiculously unacceptable that you might as well not have done it, you should have just gone surfing instead. So, what we’re going to do here is we’re going to show you how you can break down a paper fairly quickly for the purpose of doing a critique. Now, depending on the course that you’re in, your critique may be slightly different than this one. This one was recently designed by Dr. [Ojarambi 00:00:34] who is currently the chair of the Institutional Review Board. So, even if your critique that you’re doing isn’t quite in this format, understanding this format will help you when you go to submit your proposal to the IRB, especially if you’re in the grad program.

So, let’s just keep that in mind that your exact critique may be slightly different than this one. But that’s not a big deal one way or the other. All right, so the first thing is identify the purpose or research problem. And then some sub points, is the purpose of the study problem clearly identified? Does the problem statement indicate variables of interest and the specific relationship between those variables which are investigated? All right, now, if you are critiquing a nice paper, the nice paper is going to tell you all about stuff right up front. So here’s the paper that I gotten from, where is this? Cancer Nursing, Volume 43, Number 1, 2020. I actually found this on, I just looked under journals and then said, oh, cancer, let’s do that one. And then one of my areas of interest is exercise.

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NUR 705 Assignment 2.1: Systematic Article Review—Part I
NUR 705 Assignment 2.1: Systematic Article Review—Part I

So, I typed in exercise in that journal’s table of contents, bam, came right up, put it into the university library and here we go. So, the title of this is Association of Self-Leadership and Planning With Performing an Exercise in Patients With Colorectal Cancer. Now, that doesn’t directly tell you what’s going on here. But it’s almost like they decided they are going to put this into the format of the question that I like. So what is the association? What is the relationship of self-leadership, there’s a study factor, planning, there’s another study factor, with or on performing an exercise. Well, that seems like a response variable. And then in patients with colorectal cancer, and there’s your population of interest. Now, most of the time you’re not going to be this lucky to have them just give you the title like that.

Sometimes, it takes a lot of digging to find that out, and it’s not going to be in the abstract either. Sometimes you’re going to have to do it, you have to find it by actually reading the paper. So, let’s read this, well, let’s not read it, let’s just pick things out as we can go. So, here we have an introduction and usually, so in the introduction they’ll give you some background. And then usually towards the end of the introduction, is where they actually state their study goal. So, I’m going to pause while I skim this real quick. Well, that didn’t take very long. Here it is. The present study examined the association of self-leadership and planning with performing and maintaining physical activity sufficient to yield health benefits previously determined as at least 150 minutes of moderate to vigorous exercise per week in Korean patients with CRC. And CRC is, let’s see benefits of CRC 30% colorectal cancer.

All right, and you keep seeing the CCM throughout here, CCM, CCM, that is the Chronic Care Model of care. So later on you are going to be asked about theoretical framework. Well, you already know that the theoretical framework in this case is the Chronic Care Model. All right, so here is our problem statement. And from here it’s pretty self-explanatory that the study factors are number one, self-leadership and number two, planning. And then the response variable is being able to perform and maintain physical activity of at least 150 minutes of moderate to vigorous exercise per week. And then your study population, Korean patients colorectal cancer. Now, let me ask you this question. Do you think that they really, really only care about Korean patients? Or do you think that they want to be able to generalize this study to patients all over the world? And so, this is one of those questions where is the population of interest really Korean patients? Or is it really all patients with CRC?

So, that is something that you need to critique in your study. In some cases when they do a very limited population of interests like this, like when they say the population of interest is patients in our hospital. If all they really want to know is make conclusions about our hospital, then that’s the appropriate population of interest. But if they want to generalize that to the nation at large or the state or a region, or a hospital system, or the world, in that case it’s not necessarily an appropriate population of interest. So, just keep that in mind. All right, so let’s go back to our thing here. So, is the purpose of the study clearly identified? I think so, they said it really nicely. Does the problem statement indicate the variables of interest and the specific relationship? Well, it does say what they are. Now, how specifically the relationship between those variables? That might be slightly debatable.

So again, it’s one of those things where they didn’t have, they didn’t state it as a hypothesis, at least not in the introduction. It might be later on. So later on I might change what I put here. But for now I’m going to say that they did not state a specific relationship between those variables. All right, the next part is the lit review. So, is the lit review logically organized? Does it offer a balanced critical analysis of literature? And is the majority of the literature of recent origin? Is it mainly from primary sources and of an empirical nature? All right, so let’s come down to basic, they have no lit review. Alright, so their lit review is actually in the introduction. So the first thing in terms of is there an organized lit review? Well, there isn’t an organized lit review, however, there is a lit review within the introduction. So that’s the first thing.

So what you are going to have to do is go back and read the introduction and see how they did this. Now, they do talk about the problems with colorectal cancer here. Now they talk about a teachable moment that motivates patients to develop healthier lifestyles, however, many survivors contemplate practicing exercise after diagnosis. However, despite their intentions, the documented benefits of healthy lifestyle, many cancers do not follow the guidelines. And then there’s a couple studies that talk about how they are inactive. So that seems pretty logical. Then we talk about depression, fatigue and exhaustion are common in cancer survivors. And then there’s a couple studies that talk about that so that seems pretty good. Then they are going to introduce the chronic care model which is based on the assumption that improvement in care requires an approach that incorporates patient provider and system level interventions.

A critical component of the CCM model is self-management support. So, helping patients to support their own management, they are the only ones you can do, would be responsible for themselves. So then they’re going to give a few articles about that. And then next we have this idea of self-leadership. Now this might be a little bit of a translation issue because it’s a Korean article. In the United States we would say self-efficacy rather than self-leadership. But actually you have to do a little bit more digging into some of these articles to see if there’s a difference between self-leadership and self-efficacy, or if they are in fact, interchangeable terms. So but you can see here that self-leadership, they’ve got some stuff about that. And then coping planning can help a person to overcome obstructions. And so they talk about how planning is going to be part of the chronic care model and is also going to support self-leadership.

So, self-leadership is related to planning but planning is a separate concept. So, in this case the lit review is going to cover all of the big things that they are going to talk about here. The one thing that I don’t really see in here is they don’t talk about the importance of exercise. So at the bottom here they say in the research question, it says previously determined, sorry, performing and maintaining physical activity sufficient to yield health benefits previously determined as at least 150 minutes of moderate to vigorous physical activity per week and they have a citation. So, it would have been really nice if they had had a little paragraph or so talking about the importance of exercise. And that level of exercise being important. Now, up here they did have a little bit about physical activity, but it doesn’t talk about that level of activity being important. So to me that would be a weakness in their lit review.

So, coming back to here, is it logically organized? I would say yes. And then now, some of these questions are worded as yes, nos. But when you do your critique you don’t want us to say yes and move on. You want to say yes, is logically organized, here’s how it was organized. So, the first thing is it talked about cancer as a problem, then it talks about people who have cancer often want to live more healthily but they don’t. They often don’t exercise enough. Then the next part talks about the symptoms that they have such as being tired and fatigue, then it talks about the chronic care model, then it talks about self-efficacy, then it talks about the importance of planning. So, that is the structure of the lit review. You need to include that they’re not just yes. Next, does it offer a balanced critical analysis of the literature? That is really hard to say, they didn’t really present two sides, it just presented selected things that they wanted.

Is the majority of the literature of recent origin? Okay, so for that, basically looks like we’re going from number 1 through number 22. So let’s just scroll to the bottom here. And citations 1 through 22. So let’s see, 2017, 2014, 2003, 2015, 2015, 2003, 2005, 2011, 2003, 2009, 2007, 2002, 2002, 2011, 2002. Okay, 1986, 2010, 2005. Okay, so there are a couple relatively recent articles. However, most of those articles are relatively old, anywhere from 1990s to early 2000s. So, that is something that might be a concern. Now, some of those are classic articles. So, an example would be improving primary care for patients with chronic illness, the chronic care model part 2. So the chronic care model was published around 2002. So, the landmark study for that is in 2002. So that is acceptable. Some of these issues in terms of lifestyle and colorectal survivorship.

Now, it might be that there’s not newer information although I highly doubt that, still, it’s just a lot of this is kind of old. So that is an important thing that you might want to keep in mind when you’re doing that critique. So, is it of recent origin? I would say no in this case. There was a couple but for the most part they were slightly too much older. And then is it mainly from primary sources and of an empirical nature? So, looks like very few of these review studies, I was just kind of eyeballing it here as I went down. So you’d want to see are they review studies or are they original research studies? And yeah, I think that part is mostly fun. Okay, so let’s come back up now and do the next section. Theoretical framework, has a conceptual or theoretical framework been identified? Is the framework adequately described? And is the framework appropriate? Now, the answer to the first one is well, yes, and it was the chronic care model.

And they did I think a decent job of in one paragraph, actually goes into about here, in one paragraph talking about the chronic care model. And then more importantly, they talked about how self-management is important. Self-management support is important in that chronic care model. And from there then they transitioned into this idea of self-leadership. So, I think they did a pretty good job overall of describing it. And it does seem very appropriate to this particular study. We have patients who want to make a lifestyle change to improve their health, but they might not really know how to do that, or they might know how to do it but they just don’t feel that they can do it. They don’t have the power or the efficacy to do it. So, that’s the next step. Alright, next we have the aims objectives or research question and hypotheses. Have aims and objectives or research question or hypothesis been identified?

Okay, so a question is asking a question what is blah blah, blah, blah? Hypothesis is stated in the form of a declarative. We think this is the relationship. So in this case, in the introduction what I saw was a question right here, it examined the association. So the question is, what is the association of self-leadership and blah, blah, blah? Now, even though they didn’t state it in the form of a question, that’s really a research question. It’s not a hypothesis, a hypothesis would say something like, there’s an association between self-leadership and planning and we think that it will improve the ability to perform and maintain physical follow up. So that would be more of a hypothesis. And this one doesn’t really have a hypothesis, it does have a question. What are the independent and dependent variables in hypothesis or research question?

Now, here’s a case where I don’t particularly love this rubric because I don’t think there’s enough points attached to that statement. And I think that you need to have, spend more time with this independent and dependent variables in the hypothesis or research question. So, the independent variables or the study factors are going to be self-leadership and planning. Now, they’re going to actually have some way of defining that and we’ll see that in a little bit farther down when we look at the methods and the results. And then our response variable or our dependent variable is the ability to perform and maintain physical activity sufficient to yield health benefits as defined by at least 150 minutes of moderate to vigorous physical activity per week. Now, that’s a really interesting one because it can be recorded a number of different ways.

So, you could record the number of minutes that a person was able to do each week. So that would be a numerical response variable. Or you could just classify it as you did not meet it, or you met it. In which case that would be more nominal. You could also set it up as an ordinal where you say may have like less than 50 minutes, than 50 to 100 minutes, then 100 to 150 minutes, and then 150 to 200 minutes. So you can set it up as an ordinal interval that way as well. So there’s a number of ways this could be set up and we’re going to have to look farther down to see how they actually did it. Alright, so here we are with data collection. They had a questionnaire, clinical data, hospital database included these items, surveyed, self-leadership and action coping were personally administered in outpatient, okay.

Measures. Measure of self-leadership, which refers to and they define self-leadership a little bit better here. And then the abbreviated self-leadership questionnaire ASLQ was used to assess self-leadership. Okay, so that’s how they are defining self-leadership is the patient’s score on this particular thing. And we’re going to talk a little bit more about those in a minute. Then planning divided into two sub constructs which are action planning and coping planning. So action is what do I want to do? So, the process of linking goal directed behaviors to certain environmental cues by specifying when, where and how to act. And then coping planning is barrier focused self-regulation that says when there’s a problem how do I handle it? So those are the two aspects of planning. And again, they’re going to tell you about how they measured that.

Alright, exercise, here’s what we’re looking for. Practicing exercise was measured based on a seven day exercise diaries in minutes per week of at least moderate aerobic activity that consumed at least…Now, I have no idea how they decided whether it was 4 mets or not, 4 metabolic equivalents. If you’ve ever walked on a treadmill or use one of those, any of the machines, the cardio machines, they’ll report the number of mets. So one met is the amount of oxygen you consume just hanging around doing nothing. So 4 mets would be four times that. And then maintaining exercise was measured in persistence of the exercise during six months. Okay, so in this case, they wanted to, they wanted them to get at least 150 minutes of exercise in a seven week period, with at least four metabolic equivalents. So, I don’t know exactly how they did that but we’ll see later.

And then they wanted to maintain that exercise for at least six months. Alright. So in terms of the dependent variables, there’s actually more than one dependent variable. One of the dependent variables is the minutes of exercise at that 4 met rate or above. And then the second one was were they consistent over the course of six months, or how consistent were they? Alright, next we have sample. Has the target population been clearly identified? Well, yes, it was colorectal patients in Korea and I’m assuming that would be South Korea. Let’s go back up for a moment. A lot of studies will put this right in here. So, methods, this cross sectional survey enrolled 251 consecutive patients with CRC who underwent primary curative surgery and we’re receiving blah, blah, blah, blah, blah [inaudible 00:20:20].

Okay, here we go, the patient with CRC was eligible if he was older than 19, he or she was older than 19 years old, had a diagnosis of CRC as primary cancer, stages this within the past two years, and was currently using or had completed cancer therapy and had no other history of cancer. Alright, so that is going to be the inclusion exclusion criteria. So the inclusion criteria was the patients who had come into one of these two hospitals, between these dates, who had CRC, who was 19 years old, male or female. So the diagnosis was in the last two years and they were either currently on or had completed their cancer therapy. And then an exclusion criteria was history of other cancer. So, that’s your inclusion exclusion criteria. So, when we say colorectal cancer patients as a shorthand, what we really mean is a patient who met all of those criteria. Does that make sense?

So, that would be the inclusion exclusion criteria which I believe is one of the things right there. Now, it doesn’t say the inclusion exclusion criteria were, but that is pretty clear that that’s what it was doing. Now, how was the sample selected? Well, in this case, what they said was 251 consecutive patients. So what they did was they took the next 251 patients who showed up, who met the criteria during this timeframe. Does that make sense? So, was that probability or non-probability? Well, that’s non-probability. And is it of adequate sample size? It’d be a little bit different to know that for sure without reading the whole thing and I am not seeing where it says that one way or the other. Oh, sorry. One other thing we should mention here as I kept reading down a little bit. So, how did they get them? It says the research staff contacted all of the eligible patients. And when they visited for follow up or checkup or treatment.

And then they were excluded if they’re unable to read or understand Korean or communicate with others. Or if they were psychologically unstable such as severe depression, had cognitive. So here’s some additional exclusion criteria. So in that case the inclusion exclusion criteria is a little bit less clear because it’s separated into like two different parts. Okay, now among them it says this many agreed and then it talks about blah, blah, blah. And it’s not that important for answering the rest of this question. So, how was the sample selected? Well, we selected the people who are eligible. And we took 251 of everyone who came through the next number of patients who came through. So the next consecutive patients. Was it probability or non-probability? That is clearly non-probability? Is it an adequate size? They did not address that in this article.

So, what you need to say is, it’s unclear whether this was an adequate size or not because they did not discuss power analysis. Are the inclusion exclusion criteria clearly defined? Moderately so in this one. And it would be nice right there if you then listed them. Now, one other thing that I want to mention here where it says are they clearly identified? It’s not enough just to say yes they were identified. Yes, they are identified and in your opinion, are they justified? Are they adequate? When we say a patient with colorectal cancer, going back to these criteria that were listed here. Does that form a picture of, oh, yeah, that’s the person who I’m thinking about would be in the study. Or are you going, I don’t know man, two years? I don’t know, maybe we should go five years? Or maybe, well, I mean, if you’ve been cancer free for two years and you haven’t had any problems whatever, I was really interested more in people like within the last six months.

So that’s something that you need to think about and you need to critique. It is your opinion, your analysis of whether this is appropriate or not. Alright, next we have ethical considerations. Were the study participants fully informed about the nature of the research? So we see here that they did informed consent. Hold on here, informed consent was obtained from all blah, blah, blah. The most common reason for non-participation was inconvenience or time, all procedures were formed in accordance with the ethical standards of the Institutional Research Committee. And with the 1964, Helsinki declaration. The study protocol was approved by the institutional review board of the hospital and university and here’s the numbers. Okay, so in terms of ethical considerations, yes, they were fully informed. Was the autonomy confidentiality of the participants guaranteed? Well, they didn’t say, but they said they are maintaining all of the standards of Helsinki so we assume yes.

Were the patients protected from harm? Again, unless you know what those Helsinki everything else was, you wouldn’t necessarily know from reading the paper itself. And was ethical permission granted for the study? Yes, it clearly says that it was authorized by the institutional review board of both the university and the hospital. Alright, so for this particular rubric, you are pretty much done at this point, you need to go back, you need to write that out into a little bit of good sentences and analysis. For those of you who are doing the grad class and it’s going to be asking you about the study design, let’s also look at that. Okay, so for those of you who are doing the grad version of the research class, it’s a little bit different but it’s still similar enough. Everything up till this point is pretty much what we’ve talked about and then identify the response variables and classify them. Let’s just go into that into the tiniest bit more detail.

In order to do that part, what you often have to end up doing is going into the results. So, here we see results. One thing about study factors and extraneous variables, this table right here is showing extraneous variables. So the age was an extraneous variable and they did elderly versus non-elderly. Then gender was one, marital status was one, employment was one, income was one, having a religion was one, yes versus no on that one. Their residents or town for their rural or metropolitan, the number of family members they have, the colon cancer site, whether they had metastasis, the cancer stage and the treatment type. All of those according to this study are extraneous variables. Now, nowhere in this article are you going to see the term extraneous variables, but this chart is showing you what they thought were extraneous variables. Alright, that is not important for what we need.

Alright, results. Okay, so they’re going to tell you about the relationships of demographic to clinical variables with self-leadership. And then they’re going to say the same thing about with planning. And then the last thing they’re going to do is what we really cared about which was exercise. So, analysis of self-leadership and getting hated that performing moderate correlated significantly with higher self-leadership in the following sub skills. Behavior awareness and volition and they tell you some stuff. Now, this is outside the scope of what we care about. And then maintenance of moderate intensity, exercise aerobic also has significant correlations. Alright, in this particular case, I’m going to say that the way that they reported this kind of sucks. it doesn’t really make it clear. They say table four, that’s table two. Table four, here we go.

Okay, so it looks like what they did is and I’m sorry for those of you who watch this that’s everybody probably, most you got a pretty good background in statistics at this point. You’re not going to necessarily know this but just trust me that what they ended up doing was they made it into a nominal variable. So they either said, yes you did or no you didn’t in terms of exercising 150 minutes or more per week. I assume that’s just one week. And then the second one was maintaining moderate exercise intensity for at least six months. And they just basically said yes you did or no you didn’t. So it was success versus failure, which in this case is a nominal response variable in both cases. So, when you do your critique and it asks you to identify the response variables and classify them, the response variable in this case. One, is maintaining exercise for at least six months, yes or no, nominal. And the other is exercising at least 150 minutes in one week and that’s yes or no also.

Alright, evaluate the appropriateness of the response variables. So this is how they measured it. This is a hard question. So, on one hand exercise is a great thing, the way that they did it with the seven day diaries that seems pretty decent, they had them keep a log and I assume they had someone calling them on a regular basis to say, “Hey, have you been doing your log?” But when they did the final analysis all they cared about was did they meet it or did they not meet it? So someone who has 149 minutes was fail and someone who has 151 minutes was passed. And is that fair? Is that appropriate? I don’t really know. So, in terms of evaluating the appropriateness of the response variable, I would personally say that breaking down a numerical response variable and classifying it into that failed or not failed, yes or no nominal is probably not the most appropriate way to do it.

Next, we have identify factors and classify them as study or extraneous. So the factors in this case were self-leadership and planning. And both of those, they measured them on scales, so you consider those quantitative. So sure they’re quantitative. And then the other was the extraneous variables. And going back to the article for just a moment, remember that table, all of these things were your extraneous variables. Now, you should also take into account other potential extraneous variables that you can think of that may or may not have been dealt with in this article. A really big one that comes to mind is previous training history. So someone who is already active for 150 minutes or more a week, might be more likely to do that after their diagnosis than someone who’s never exercised at all. They also really didn’t mention mets. So the intensity of the exercise itself could also be a study factor.

There’s a big difference between doing 4 mets and 10 mets. So let’s just say that someone was doing 4 mets and someone else is doing 8 mets. Yeah, they’re both meeting the minimum, but there’s a really big difference between those. So that might be another extraneous variable that you could measure. But anyway, for the most part I think they did a pretty good job on that extraneous stuff. Alright, next we have identify the study design and time perspective. So this one is pretty straightforward in a lot of articles and some articles it’s not quite a straightforward. This one tells you right up front in the title or…Was that right up there? Cross-sectional study right there. So, what’s the study design? It’s a cross-sectional study. Now, is that really true? Oh, man, I don’t know what it is. Let’s come back down the methods for a moment. Okay, so a cross-sectional survey is when it’s really just a one-time event. So you identify the person and you collect their data right then.

So were we asking them how much exercise did you do in the last six months and just taking their word for it? Or were we identifying them, measuring their self-leadership and then coming back six months later and saying, hey, do you want to do this? Over here we said, yeah, okay. So, here is a big limitation of this particular study is it’s not 100% sure how they actually collected the exercise data. Because they are calling it a cross sectional study, I’m beginning to think that they basically just brought them in and said, “Hey, how’s your self-leadership? Hey, how’s your planning? Here’s these questionnaires that measure those things.” And then “Hey, how much exercise have you done in the last six months?” And then go on from there. So, I’m not crazy about that. But anyway, that’s what a cross-sectional study is. A cross-sectional study because the data exists at that moment.

The data exists in the patient, you’re not waiting to the future to collect data. That means that it’s a retrospective study. So, for those of you who haven’t gotten to that point in the course yet, well, just take my word for it. So, identify the study design and time perspective. It is a cross sectional study and it is a retrospective study. Then analyze the usefulness or completeness of the methods section. So, I’ve just been commenting on that right there. Do you understand what was done in the study? Yes, mostly. Are there problems with it? Yes, there’s some problems with it, because it’s not quite clear how they collected the exercise data. And if they collected exercise data that way, well, that’s not really that useful in my opinion.

I think a much stronger study, although a much more difficult study to do would be, let’s assess their self-leadership and their planning. Let’s see what happens over the next six months and get in touch with them and see how much they’ve exercised in that six months. Of course, that’s also more expensive and it takes longer and patients might die or move away or forget to call your back or whatever. So you probably need even more patients than 251. Now, summarize the author’s conclusion what they think not what you think. So this is really difficult for some people, don’t put yourself into this one, just say what the author says. So let’s come all the way down to the conclusion. All right, here we go, conclusions. The findings of the current study indicate that the presence of self-leadership and action planning are significantly associated with performing and maintaining an exercise.

That’s a funny way of putting it. Cancer survivors must have greater self-leadership and be capable of action planning to experience improvements in chronic illness performance measures and to avoid psychological withdrawal so it can achieve the targeted behaviors. We believe that self-leadership and action planning enabled managing their own care throughout the cancer continuum. We suggest that self-leadership and action planning be considered as critical components force support management by cancer patients. So these individuals can help provide long term care for themselves. Alright, so that is their conclusion. And so you’re basically just going to summarize that to say the patients think or the authors think that having greater self-leadership and planning is highly associated with being able to better maintain exercise after cancer diagnosis over six months’ time. And just leave it at that. That’s what they thought.

Now, the next question is going to be, give your informed reasoned opinion about the conclusion of the research as a basis for nursing practice. Does the article as a whole match the abstract? And would you recommend any changes in patient care or nursing practice as a result of this study? So, let’s go back to this for a moment. Now, I’ve kind of skipped over it. But right here implications for practice, you should probably also include this in your summary of the conclusion. So, the conclusion would be not just what they’ve labeled the conclusion, but also the implications for practice and also their study limitations. So really all of that should be part of their conclusion. Now, this last part is what do you think about it? So going back up to the top, one of the questions that it asked was how closely does this abstract actually match what they did in the study?

So personally, I think it does a pretty decent level of doing it. Yeah, so overall, I think it’s pretty good article. And I think that it matches in what it does. The one thing that I would be cautious of and this is something that you will have to know with time, is because it’s not just about a single article in isolation, it’s about multiple articles together that form a picture. And one of the things that we know is that from psychological research is that almost all psychological variables can be explained by what’s called the Big Five, openness, conscientiousness, extraversion, agreeableness and neuroticism. So conscientiousness, is very, very strong part of self-leadership and also of planning. So, is it possible that these are things that a person just has innately, or they things that we can foster and build?

So it could be that we actually can’t change people’s ability to do things because their a personality trait and not learn behaviors or learned skills in their head. On the other hand, it could be that we do. So, although this article says, “Hey, we found that being highly self-leadership and having good planning is associated with better being able to do exercise.” That doesn’t mean that just because you try and improve those things that someone’s going to be able to do more exercise. So that is another piece of research that needs to be done. So there you go, that took about 40 minutes for me to talk through. And I didn’t read this article ahead of time on purpose just so you can see that it’s possible to pick this stuff out.

So really, I think you guys should be able to do this in no more than two hours. If it’s taking you longer than two hours what that means is either one, you’ve got a really complicated article or number two, you don’t understand the concepts well enough. In which case, it’s probably a good idea for you to contact me and I’ll talk to you later. Bye.