Reducing anxiety with exercise, mindfulness, and pharmaceuticals.

We had to come up with a PICO question for our paper topic. “In middle age women, how does exercise and mindfulness help reduce anxiety when paired with traditional pharmaceuticals or without pharmaceuticals?” At least 3 sources. More can be used though. See attached documents for details and RUBRIC.Scholarly Literature SearchFor this assignment, you will practice using a scholarly database to do a literature search for evidence based on your PICO clinical question. This will be your first search; you may need to revise your search based on assignment feedback and finding articles for your EBP paper.For this assignment you must select one scholarly database to search, either PubMed or CINAHL (include choice below). In an actual EBP project you would want to search both and possibly other databases. You may want to try searching both databases and see which one provides you with results that best match your PICO question before completing this worksheet (you only need to include information for one in the worksheet below).Next you need to develop your “search strategy.” This is what you will enter the “search” box in PubMed or CINAHL. Use your topic and your PICO question to carefully select words for this search. Read the textbook assigned readings and watch the lectures for this week BEFORE developing your search strategy. Do NOT write your PICO question as a sentence in the search box in PubMed or CINAHL. While this might work when you do a Google search, this will NOT give you good results when searching a scholarly database. Instead, you will need to identify “key words” for your search strategy and use those in the search box, along with necessary Boolean operators (“AND”, “OR”, “NOT”)You CAN use keywords that are not written in your PICO question. Often you need to identify and use synonyms when doing a keyword search. Often authors refer to the same topic using different terms.For example, “post-surgical” and “post-operative” both refer to the time after a patient has had surgery. If your topic was postoperative infection you might want to include both terms in your search using the Boolean operator “OR” and type the following search strategy:Infection AND (postoperative OR postsurgical OR post-operative OR post-surgical)If you are not satisfied with the number of articles, you see you can revise your strategy as necessary before writing your exact search strategy below (answer to question #2).Answer the rest of the questions below based on how you conducted your search and how many articles you found.1. Name the scholarly database you will use for your first search? (PubMed or CINAHL)PubMed2. Write the exact search strategy that you entered in the search box of the database for your literature search, including any Boolean operators, quotation marks, parentheses, or truncation that you used (copy and paste what you used). This is your “search strategy” (see example above).exercise and mindfulness practice AND (pharmaceuticals OR reduce anxiety OR middle-aged women)3. Did you use any limits or filters for your first search, such as English only articles or adult population? (Yes or no) If yes, list the filters you used. DON’T use the full-text only filters! That refers to articles that are available for free to the public, it does NOT include articles you have access to through the library by being a student.Filter used: English only articles, female subjects, middle aged 44-65, 2016-2021.4. How many articles did you find in this search (give number)?  32That is a very manageable number of articles to skim through. When I used the same search strategies as you did, I saw a lot of articles about mindfulness, but not necessarily in comparison to medication as treatment. Some of the articles compared mindfulness to exercise. If you are having trouble finding 3 articles that match your PICO question well, you might want to try revising your search a little. You could choose exercise OR mindfulness. I also tried using (pharmaceutical OR medication) too. Let me know if you need any assistance.Instructions and Grading Rubric for Evidence-Based Practice PaperFor this project you will identify a clinical topic of interest, find evidence about that topic, critically appraise the evidence, and present your appraisal of the evidence in a paper.The project will be completed using the following timeline and steps:Write a first draft of PICO-formatted clinical question (week 2)Conduct first literature review to find evidence to answer your PICO question (week 3)Revise your PICO clinical question, if necessary (week 4)Revise your literature review, select articles, and upload articles to ICON (week 5)Analyze the articles (weeks 6 to 15)Summarize the results of your analysis in the paper (due week 16)The Evidence Appraisal Project paper will be approximately 4 to 7 pages (with references, no absolute page limit) and worth 30% of your course grade. Your grade on the paper will be based on whether you included all of the necessary information outlined below. Therefore, some papers may be longer or shorter.Articles for PaperIn clinical practice you can’t control how much evidence is available for the clinical topic you are interested in. However, for this paper you will be required to use 3 scholarly articles. This paper is a practice exercise to teach you the process for reviewing and critiquing evidence for practice.Formatting of PaperYour paper is expected to have correct APA 7th edition citations and references, correct spelling, and appropriate language and grammar. You are also expected to follow the directions below for the structure and content of your paper. When submitting a manuscript for publication, journals and publishers require that authors follow strict guidelines to format their manuscript. The instructions below give you guidelines to follow for writing and formatting this paper.The following sections must be in your paper:IntroductionSummary of evidenceClinical recommendationsReference list Detailed instructions for the paper are presented below:FormattingDouble-spaced with one-inch marginsFont should be Arial, Calibri, or Times New Roman and font size 12Title page (this is DIFFERENT from typical APA formatting)Title of your paper (your topic or shortened version of your clinical question)Your nameThe name of the school (University of Iowa).Page 2This page should begin with the title of your paper at the top.The line immediately after the title will be your “Introduction” section of the paper (see separate grading criteria).You do NOT need to use a running head.HeadingsThe introduction section does not have a heading (title of paper is above it), but the remaining sections of the paper (Summary of Evidence, Clinical Recommendations and References) should all have headings with the name of the section writing in bold, centered and including capitalization of the main words.General GuidelinesDo not plagiarize. I will be using an electronic plagiarism checker. Plagiarism is:Copying an author’s exact words, but not putting quotation marks around the copied words or providing a citation of the author’s original article (author name, year, page number).Paraphrasing or summarizing an author’s idea, but not providing a citation of the author’s original article (author name, year)Less than 20% of your paper should be direct quotations from your sources—paraphrase the information instead!  The ability to paraphrase information is an indicator that you understand the information.  If more than 20% of your paper consists of direct quotations, points will be deducted from your total paper score. Cite your sources correctly when quoting and paraphrasing.When referring to a scholarly article, use the author(s) last names and year of publication of the article, not the title of the article.For example, this is correct: “In an experimental study Bandura, Ross and Ross (1961) had preschool children observe adults demonstrating aggressive behaviors with toys before telling the children they could play with the same toys. The authors described the aggressive behaviors displayed by the adults in detail, including the list of available toys: a doll, a mallet, a tinker toy set and an inflated Bobo doll. ”For example, this is INCORRECT:“In the article “Transmission of aggression through imitation of aggressive models” preschool children observed adults demonstrating aggressive behaviors with toys before the children were told they could play with the same toys. The article described the aggressive behaviors displayed by the adults in detail, including the list of available toys: a doll, a mallet, a tinker toy set and an inflated Bobo doll.”Refer to your APA 7th edition publication manual for more about how to correctly write about an article in a scholarly paper. Points will be deducted for using the wrong style for referring to a scholarly article.Introduction Section ContentThe first section of your paper will be the introduction.  This section should begin on the second page, just below your paper’s title. In this section the information you need to include is:Your project topic (name it, such as “My project topic is…”)Brief description of why your topic is important for patients. You must provide a citation to a source of evidence about what the topic is important for patients. This information may be found in any of the articles you have collected for the paper. Remember that the introduction of most research articles describes the research problem the authors were focusing on—the research problem USUALLY describes problems the patients are having related to the topic. Your group’s PICO question for this project, clearly including all 4 parts.Appraisal of Evidence SectionThe second section of your paper should have the heading “Appraisal of Evidence”.  In this section you will provide information about the specific articles that you collected for this project. This summary should be written as a narrative (in paragraph form), and not as a list. Put the articles in the order that makes the most sense for your topic (no specific order is required). For each article provide the following information:Brief description of each article. This description should be a short paraphrasing of the purpose of the article (1-2 sentences) and the type of evidence the article is (experimental study, systematic review, etc.). For example:“Thomsen and colleagues (1998) conducted an experimental study in which they compared time required to heal a pressure ulcer between patients who received a diet with extra protein and patients who received the standard hospital diet.”Describe the results/conclusions of each article that are RELATED to your PICO question. You don’t need to describe additional information from the article that was not part of your question. If your article does not relate to ALL your PICO question, describe only the relevant parts. For example, if your PICO question was “In nursing home patients with pressure ulcers, does receiving a high protein diet, as compared to a standard diet, affect the time required for wound healing?”, you might give the following description of the results of a study:“Patients who received a diet with extra protein had significantly shorter times for healing (2 weeks) compared to patients who received the standard hospital diet (four weeks).”-OR- for an article that is only about one part of the PICO question (pressure ulcers in nursing home patients) you might give the following description of the results/conclusion of the article:“The authors concluded that more than half of nursing home patients will eventually experience a pressure ulcer. While there are many reasons that pressure ulcers develop, an inadequate diet may increase a patient’s risk for pressure ulcers.”Critique TWO aspects of each article, label each as a strength or weakness and then explain WHY each it is a strength or weakness. You can identify two weaknesses, two strengths, or one weakness and one strength. You must clearly state if you are describing a strength or weakness and you must provide a correct explanation of why it is a strength or weakness for each one. You are expected to use information from your textbook, other assigned readings, and lectures to explain why each is a strength or weakness. For example:“A strength of the study by Thomsen and colleagues (1998) is that they used a randomized controlled trial for their research design. A randomized controlled trial is a strength because the intervention and control groups are assigned randomly, which reduces selection bias. A weakness of the study is that the authors only used a sample of patients from one nursing home in western Connecticut. This is a weakness because the patients in this nursing home may not be representative of patients in other locations or settings.”Clinical Recommendations SectionThe third section of your paper should have the heading “Clinical Recommendations”.  In this section include the following:Does the evidence you evaluated support changing clinical practice? Based on reviewing your articles, give your opinion on whether the evidence you found supports using the results in clinical practice.For example, “Based on the evidence collected, TENS units should be used to treat pain in….” OR “Based on the evidence collected, more research is necessary before TENS units are used in typical clinical practice.”Remember, this is an assignment for you to demonstrate the beginning competencies you have developed in this class in gathering and appraising research evidence. In a “real-life” evidence-based practice project you would NOT limit the number of articles you selected. This limitation is included in this paper to make sure the paper can be completed during the course.Explain why the evidence supports changing practice or does not support changing practice. You can refer to an article’s purpose, strengths/weaknesses, and/or results/conclusions to support your opinion. You don’t need to repeat all the information you wrote for each article in the previous section of the paper. Choose 1 or 2 examples from what you have written in the “Appraisal of Evidence” section to support your opinion and add citations as appropriate. For example:“Stuart and colleagues (2019) reported that giving parents the choice of being in the room while their child was being resuscitated decreased depression scores in parents. Authors of the other articles examined have reached similar conclusions (Black et al., 2010; Reagen, 2013).”-OR-“Stuart and colleagues (2019) reported less depression in parents who were given the choice of being in their child’s room during resuscitation. However, Billard (2015) and others also found higher anxiety symptoms in parents who watched their child’s resuscitation (Black et al., 2010; Reagen, 2013).”In the last part of your paper, you should include a separate page with the heading “References” and list all the references you cited in the paper, in 7th edition APA format.         Submit your paper by the due date to the ICON drop box for the Evidence-Based Practice Paper. You may need to click the button that states, “Load Evidence-based practice paper in a new window” to upload your paper.Grading Rubric for Evidence Appraisal ProjectCriteriaPointsScoreFormattingDouble-spaced, 1-inch margins, font size 12, title page correctly formatted2Correct APA inline citations33 = no errors or minimal errors, 2 = some errors, 1 = frequent errors, 0 = none of the inline citations were formatted correctlyCorrect APA references3Overall spelling and grammar3Direct quotations >20% of paper*Points subtracted based on amount over 20%*IntroductionProject topic2Effect on patients with appropriate supporting citation3Population for PICO question2Intervention for PICO question2Comparison group for PICO question2Outcome(s) for PICO question2Summary of EvidenceBrief concise descriptions of purpose of articles and types of sources provided6Results/conclusions related to PICO question provided for each article6Two critiques of each article provided6Each critique clearly labeled as a strength or weakness6Rationale that explains WHY each strength or weakness is a strength or weakness is provided, rationale is clearly written and correct6Clinical RecommendationsDoes the evidence support changing clinical practice?2Clear rationale for why practice should be changed (or not changed), gives one or two examples from articles.4Total60

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