Rough draft quantitative research critique and ethical consideration
Dementia is a group of signs and symptoms reflecting diminished cognitive function. The cognitive abilities affected are thought comprehension and reasoning. Loss of these abilities usually interferes with routine activities conducted by the affected population. Older patients with dementia are prone to falls. This has been attributed to forgetfulness and unawareness of their surroundings. It is an important clinical problem because it causes regular physical harm. This paper provides a critical appraisal of two quantitative research articles and how the results from the articles can be incorporated into nursing practice.
Background of the Study
The first article is authored by Oki et al. (2021). The researchers focus on three main factors attributed to falls in older people with dementia. These factors include balance, vision, and cognition. The target group of the study is older patients with dementia who have a past fall history. The comparison group is the population that has not had a fall. The three factors were compared between the two groups, and the results were used to make a conclusive finding on the impact of each factor.
According to Oki et al. (2021), the purpose of the study is to determine the main risk factors for falls in patients with Alzheimer’s disease. The study’s objective is to identify the impact of three risk factors for falls in Alzheimer’s patients with a fall history versus those without a fall history. Three research questions arise from the study. The first question: how does balance contribute to falls in patients with Alzheimer.? The second question: what is the impact of cognition on falls in patients with Alzheimer’s disease.? The third question: what is the impact of the visuospatial ability on falls in people with Alzheimer’s disease.? The three research questions demonstrate the significance of the study to nursing practice. These results will enable nursing personnel to focus on the key indicators of falls and their mitigation strategies. This will help to reduce subsequent incidences of falls in the target population, older people with Alzheimer’s disease.
The second quantitative research article is authored by Sharma et al. (2018). Factors that increase the likelihood of falls in patients with dementia include age, gender, history of falls, environment, and the type of dementia. Furthermore, medications were identified as risk factors for falls. The authors report the importance of considering environmental factors as potential causes of falls and related fractures. Sharma et al. (2018) indicate that cognition and psychiatric manifestations have little impact as etiological factors for falls in patients with dementia.
According to (2018), their study aims to investigate the predictors of falls and associated fractures in patients with dementia. The objective of the study is to conduct a representative cohort study and identify indicators of falls and fractures in patients with dementia. The research question: among patients with dementia, what are the predictors of falls and related fractures.? This research question does not focus on a specific etiological factor but aims to identify all potential factors. Nursing practice will benefit abundantly from the results of this study. Information from the study will enable nursing personnel to establish a framework for preventing falls in patients with dementia. Besides, it will enable them to educate patients’ caregivers and relatives on the predictors of falls. This will lead to a significant decline in the number of falls and a better quality of life.
How the Articles Support the Nursing Problem
My nursing practice problems are falls and dementia. My PICOT question: For patients who suffer from dementia-related falls, does screening for prior history of falls, age, and visuospatial ability compared to screening for cognitive impairment level help predict and prevent subsequent falls over six months? The two articles are relevant and will be used to answer the PICOT question.
The research article by Oki et al. (2021) identifies the relationship between three key risk factors and falls in patients with Alzheimer’s disease. The discussed factors include balance, vision, and cognitive impairment level. Oki et al. (2021) focused on patients with a history of falls and those without a history of falls. Findings indicate that balance and visuospatial ability were key predictors of falls in patients with a history of falls. Patients with a history of falls recorded lower scores for both parameters compared to their counterparts. Cognition did not predict the incidence of falls in both groups of patients with dementia.
The second article by Sharma et al. (2018) identifies indicators of falls and associated fractures in patients with dementia. The researchers identified numerous predisposing factors. History of past falls, age, gender, and the environment are listed as the causes of falls in people with dementia. Cognition and psychiatric manifestations of the patient are not important indicators of the likelihood of falls. These findings are consistent with those reported by Oki et al. (2021). Therefore, information from both articles suggests that cognition is not likely to cause falls in patients with dementia. Key risk factors include balance, age, history of falls, and vision. These will help answer the PICOT question by recommending screening for prior history of falls, age, and visuospatial ability.
The researchers in both articles propose various interventions. Both propose that cognition should not be the point of focus when predicting the likelihood of falls in patients with dementia. Oki et al. (2021) report the importance of screening for balance and visuospatial ability, whereas Sharma et al. (2018) propose screening for past fall history, age, and environment. Oki et al. (2021) use a comparison group of those without a history of falls. This is different from that used in the PICOT question. However, results from the study by Oki et al. (2021) incorporate the comparison group of the PICOT question.
Method of Study
Oki et al. (2021) used a retrospective cross-sectional study, whereas Sharma et al. (2018) utilized a retrospective cohort study. The retrospective cross-sectional study involved assessing the three risk factors and their outcomes in a similar time frame. The risk factors include balance, cognition, and vision. The results demonstrate that balanced cognition and a history of falls were key risk factors for falls in patients with dementia. The retrospective cohort study involved collecting data from patients over six years, from the beginning of January 2007 to March 2013. After that, various factors that led to falls and hospitalizations of the patients were recorded. This information was used to identify the indicators of falls in patients with dementia.
A retrospective cross-sectional study can be used to authenticate the preexisting assumptions. This is because it allows the assessment of risk factors and their outcomes in a similar time frame (Talari & Goyal, 2020). These findings can be analyzed and form the basis for new theories and further research. The disadvantage of the method is the inability to analyze a factor over a long time. It focuses on a particular timeframe rather than a prolonged duration.
A retrospective cohort study can be used to study multiple parameters and identify numerous outcomes. Unlike the cross-sectional study, risk factors and outcomes are not analyzed in a similar time frame (Ranganathan & Aggarwal, 2018). The method is costly and time-consuming. An example is a study by Sharma et al. (2018), which focuses on analyzing data over six years. The entire process will take several months, and a lot of money will be spent on analysis.
Results of Study
The study by Oki et al. (2021) reveals that 46.8 percent of the participants had a history of falls. The results revealed that balance and visuospatial ability were key determinants of falls in people with a history of falls. The mean scores for balance tests were 19.5 and 2.5 for the Functional Reach Test and one-leg standing duration, respectively. The comparison group without a history of falls scored higher, 26.1 and 8, respectively. Mean scores for visuospatial ability were 3 for the fall group compared to 6 scored by those without a history of falls. The low scores by the group of participants who had a history of falls indicate that balance and vision are key risk factors for falls. On the cognition test, people with a history of falls got a higher mean score, 16.7, than those without a fall history, 16.2. This result indicates that cognition is not a predictor of falls in this population.
The study by Sharma et al. (2018) reported similar results on cognition. Participants with a history of falls got a mean score of 19.9 on the cognition test, while their counterparts scored 19.5. This supports Oki et al. (2021) findings that cognition had no impact on predicting falls in patients with dementia. Sharma et al. (2018) report that about 70 percent of participants with a history of falls were females. Furthermore, the average age at which dementia was diagnosed was 82 and 80 years, respectively, for those with and without a fall history. Medications such as antidepressants were identified as risk factors. Twenty-six percent of those with a fall history, compared to 23 percent of those without a fall history, were on these medications.
Results from these studies are relevant to nursing practice. They will enable nursing personnel to identify key predictors of falls in patients with dementia. This will enable them to set up preventive measures to educate other healthcare providers, patient’s relatives, and caregivers. The quality of life of people with dementia will improve when this is implemented.
Outcomes Comparison
The anticipated outcomes for my PICOT question can be categorized twice. The first outcome is to predict the occurrence of falls in patients with dementia over six months. Subsequently, the second outcome is to prevent the occurrence of falls in patients with dementia over six months. The outcomes of the two articles identify predictors of falls in people with dementia. Both articles report that cognition is not a risk factor for falls. Subsequently, risk factors for falls include balance, age, history of falls, medications, and vision. These outcomes will help to fulfill the anticipated outcomes of the PICOT question. In addition, they will help to predict the likelihood of falls and decide the best preventive strategies.
References.
Oki, M., Matsumoto, M., Yoshikawa, Y., Fukushima, M., Nagasawa, A., Takakura, T., & Suzuki, Y. (2021). Risk Factors for Falls in Patients with Alzheimer Disease: A Retrospective Study of Balance, Cognition, and Visuospatial Ability. Dementia and Geriatric Cognitive Disorders Extra, 11(1), 58–63. https://doi.org/10.1159/000514285
Ranganathan, P., & Aggarwal, R. (2018). Study Designs: Part 1-An Overview and Classification. Perspectives in Clinical Research, 9(4), 184–186. https://doi.org/10.4103/picr.PICR_124_18
Sharma, S., Mueller, C., Stewart, R., Veronese, N., Vancampfort, D., Koyanagi, A., Lamb, S. E., Perera, G., & Stubbs, B. (2018). Predictors of Falls and Fractures Leading to Hospitalization in People With Dementia: A Representative Cohort Study. Journal of the American Medical Directors Association, 19(7), 607–612. https://doi.org/10.1016/j.jamda.2018.03.009
Talari, K., & Goyal, M. (2020). Retrospective studies – Utility and Caveats. Journal of the Royal College of Physicians of Edinburgh, 50(4), 398–402. https://doi.org/10.4997/
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Question 
Write a critical appraisal that demonstrates comprehension of two quantitative research studies. Use the “Research Critique Guidelines—Part II” document to organize your essay. To complete this assignment, you must provide a rationale, include examples, and reference content from the study in your responses.
Rough draft quantitative research critique and ethical consideration
Use the practice problem and two quantitative, peer-reviewed research articles you identified in the Topic 1 assignment to complete this assignment.
In a 1,000–1,250 word essay, summarize two quantitative studies, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.
You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.