Although not indicated in the article, it is clear that the researchers wanted to answer the question “what are the barriers and enablers to implementation of a New Zealand‐wide guideline for assessment and management of cardiovascular risk in primary health care?” (McKillop, Crisp & Walsh, 2012).
Who participated in the study?
Back exercise and EA treatment were the independent variables in the study, which were used to treat the subjects in order to observe the outcomes
On the other hand, the primary outcomes measured in the study were “pain” and “disability”. Accordingly, these outcomes were dependent on the variability of the independent variables. However, the researcher could not vary them directly. Thus, they were the dependent variables. As such, they were the dependent variables
The researchers used a sample of 52 patients randomly chosen from a group of patients referred to the hospital for medical officers in charge of the outpatient clinic at the Orthopedics and Trauma Department at the Kwong Wah Hospital in Hong Kong.
What methods were used to collect data?
The study was based on a quantitative approach. The patients were placed into two groups at random- the groups treated with “back exercise” and the group treated with “exercise combined with EA”. The exercise only group was the control group while the exercise plus the EA group was the experimental group
The dependent variable of pain was measured using the Numerical Rating Scale (NRS). It was used to measure the average and worst pain intensity experienced by the patients based on their reported level of pain intensity on a scale ranging between 0 and 10. The reliability of this measuring instrument was relatively high because the reported pain was an individual’s perceived intensity of pain, which allows both illiterate and literate patients to report what they felt rather than what they knew.
On the other hand, the disability variable was measured using the Aberdeen LBP scale, which effectively measured the level of low back disability in the patients. It is one of the most reliable techniques of measuring variables in the world, with the Chinese authorities recommending it as the only tool for measuring the variable in the country.
The nature of the patients was used to determine the types of data included in the experiment. For example, socio-demographic characteristics such as each patient’s age, weight, sex, height, past diagnosis, duration of symptoms and radiation of symptoms were considered.
What were the main findings?
Noteworthy, the study was quantitative research. The researchers used a statistical approach to answer the research question identified above. The patients’ characteristics in terms of age, gender and the nature of the condition were measured. They were used to describe the differences between the outcomes of treatment with “exercise only” and “exercise plus EA” in patients with low back pain. These statistics were used to describe the outcomes in the form of the levels of disability and pain of the participants. The researchers chose a level of significance of 0.05 in determining the relevance of the relationship between the two sets of variables. Therefore, it is clear that the aim of using the statistics was to describe the relationships between the variables.
The analysis indicates that one of the most important barriers to implementation of the guidelines is the lack of facilitation guidelines into nursing practice. Therefore, implementation plans for addressing the complexities as well as concerns of practice are necessarily to solve these issues. Nevertheless, the PARIHS framework is an effective method for solving the problems when applied in daily nursing practice.
From the study, it is evident that the New Zealand nursing practice is set to benefit from the application of the PARIHS guidelines. In fact, it is comparable to the use of the evidence-based practice (EBP) in the United States, which has increased the knowledge that nurses require to execute their daily duties.
McKillop, A., Crisp, J., & Walsh, K. (2012). Barriers and Enablers to Implementation of a New Zealand‐Wide Guideline for Assessment and Management of Cardiovascular Risk in Primary Health Care: A Template Analysis. Worldviews on Evidence‐Based Nursing, 9(3), 159-171.