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NRS-433V Rough Draft Quantitative Research Critique and Ethical Considerations

NRS-433V Rough Draft Quantitative Research Critique and Ethical Considerations

NRS-433V Rough Draft Quantitative Research Critique and Ethical Considerations

Job-related stress is one of the health problems that nurses face in their practice. Nurses are highly predisposed to stress due to the complex nature of the interaction that they have with their environments. The persistent exposure of nurses to complex demands of care in their workplaces predisposes them to chronic stress as well as other pathological problems such as burnout and job dissatisfaction. Persistent exposure to stressful conditions often leads to emotional exhaustion, disengagement and loss of interest in work (Shariatkhah et al., 2017). The effects of job-related stress on nursing and quality of nursing care are documented in studies. Accordingly, stress predisposes nurses to negative health outcomes that include depression, anxiety, and job dissatisfaction. It also increases the risk of high rate of turnover among them, high rates of medication errors and safety issues in healthcare, and high costs of operation. Interventions such as cognitive behavioral therapies are effective in reducing the effects and impacts of job-related stress in nursing (Bagheri et al., 2019). However, its use has not been explored in my practice. Therefore, the purpose of the project is to explore quantitative studies that investigated the use of cognitive behavioral therapies in managing stress among nurses. The PICOT question is, in registered nurses working in the emergency department, does the education on cognitive behavioral therapy reduce job stress when compared to no intervention within 8 months? The significance of the project to nursing is that it will improve safety, quality, and cost-efficiency in patient care.

Background

             The studies by Bagheri et al., (2019) and were selected for this review. The study by Bagheri et al., (2019) determined the effects of teaching stress-coping strategies as well as cognitive behavioral therapy on burnout and stress to nurses. The problem that necessitated this study was the limited evidence on the effectiveness of cognitive behavioral therapy on burnout and stress among nurses. The significance of the study to nursing is that it bridges the gap in evidence on the effectiveness of cognitive behavioral therapy in job-related stress and burnout. The research question for the project was not stated. It can however be inferred to have been, what is the effects of teaching stress-coping strategies and cognitive behavioral therapy on burnout and stress among nurses? The study by Shariatkhah et al., (2017) was conducted with the aim of determining the effects of cognitive behavioral stress management on stress experienced by nurses. The nursing problem that informed this study was the high prevalence of job-related stress among nurses with scarcity of evidence on efficacy of cognitive behavioral stress management strategies. The significance of the research to nursing is that it informs the quality improvement interventions that can be used to improve the health and wellbeing of nurses. The research question can be inferred to have been, what are the effects of cognitive behavioral stress management on nurses’ job stress?

How They Support Practice Issue

            The articles by Shariatkhah et al., (2017) and Bagheri et al., (2019) answers the PICOT question of the proposed project. The study by Shariatkhah et al., (2017) investigated the effects of a cognitive-behavioral stress management program on stress among nurses. The study showed that the use of cognitive-behavioral stress management program was associated with a significant decline in the stress levels among nurses. The article therefore answers the PICOT question by showing that the use of cognitive behavioral interventions are effective in reducing stress experienced by nurses in the workplace. The study Bagheri et al., (2019) investigated the effects of group cognitive behavioral therapy and stress-coping strategies on burnout among nurses. The results of the study showed that group cognitive-behavioral therapy and stress coping strategies were effective in reducing burnout and its correlates that included stress among nurses. This study will answer the PICOT question by showing the beneficial effects of cognitive behavioral therapy in reducing stress among nurses. The interventions and comparison groups in the selected articles also compare to those identified in the PICOT question. The study by Shariatkhah et al., (2017) used nurses and cognitive behavioral therapy in their investigated. Similarly, the research by Bagheri et al., (2019) investigated the effect of cognitive behavioral therapy using nurses. The focus was on stress among nurses, hence, similarity to the PICOT question.

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Methods of the Studies

            The selected studies utilized quantitative study designs. The methods used in both studies were the same. Both studies utilized

NRS-433V Rough Draft Quantitative Research Critique and Ethical Considerations
NRS-433V Rough Draft Quantitative Research Critique and Ethical Considerations

semi-experimental/quasi-experimental study design to investigate the effect of cognitive behavioral therapy in stress levels among nurses. The study by Bagheri et al., (2019) used a larger sample size (60 nurses) when compared to that of Shariatkhah et al., (2017) (40 participants). Both studies were also pre and post-test interventional investigations. One benefit associated with semi-experimental study design that were used in the articles is that the studies utilize less resources to undertake it. The study is however associated with the weakness of not utilizing randomization. Randomization affects the reliability and validity of the study outcomes.

Results

            The study by Shariatkhah et al., (2017) showed that cognitive behavioral stress management was associated with a significant decline in stress level among nurses. The researchers found that there was a significant reduction in the mean score and standard deviation in stress levels among the nurses post-intervention. The mean score and standard deviation before and after intervention were 3.48 (0.22) and 2.8 (0.2) in the group that received the intervention and 3.48 (0.21) and 3.56 (0.2) in the control group. The study by Bagheri et al., (2019) found that cognitive behavioral intervention and stress-coping strategies were effective in reducing burnout among nurses. The effectiveness of the interventions were maintained after one month of the study. The implications of the two studies on nursing is that cognitive behavioral therapy is an effective intervention that can be used for stress management. Nurses should advocate its use for the promotion of safety and quality in nursing care.

Outcomes Comparison

One of the anticipated outcomes of the PICOT question is the reduction in the level of stress among registered nurses working in the emergency department. The use of cognitive behavioral interventions is expected to reduce the perceived level of stress that nurses experience in their workplace. The other outcome is the nurses developing effecting coping strategies for managing job-related stress. It is also expected that indicators of safety and quality will decline with the implementation of the intervention. The indicators will include the rate of medication errors and adverse events in the emergency department. The implementation of the intervention is also expected to result in an improvement in the level of job satisfaction among nurses. The improvement is anticipated to reduce the costs incurred in the organization due to hiring and retaining new nurses. The anticipated outcomes of the PICOT share close similarities with those reported in the selected articles. Accordingly, the outcomes in the selected articles included the reduction in stress levels and burnout among the nurses. The focus in the PICOT question is also on the reduction in the levels of stress among nurses. Therefore, it is anticipated that the project will provide critical insights into the success and weaknesses of the intervention in improving the mental health and wellbeing of nurses working in the emergency department.

Conclusion

The review of the selected quantitative articles shows that job-related stress is a critical issue in the nursing practice. The use of cognitive behavioral strategies are effective in minimizing the effects of job-related stress among nurses. Cognitive behavioral therapy strategies reduce the levels of stress among the affected nurses as well as its indicators such as burnout. Health organizations should therefore explore the ways in which cognitive behavioral therapy can be used to minimize the negative effects of job-related stress among nurses.

References

Bagheri, T., Fatemi, M. J., Payandan, H., Skandari, A., & Momeni, M. (2019). The effects of stress-coping strategies and group cognitive-behavioral therapy on nurse burnout. Annals of Burns and Fire Disasters, 32(3), 184–189.

Shariatkhah, J., Farajzadeh, Z., & Khazaee, K. (2017). The Effects of Cognitive-Behavioral Stress Management on Nurses’ Job Stress. Iranian Journal of Nursing and Midwifery Research, 22(5), 398–402. https://doi.org/10.4103/1735-9066.215683