Inquiry in Health Care Emotional Stress

Question: Discuss about theInquiry in Health Care: Emotional Stress. Answer: Introduction The report critically appraises the research article by von Haaren et al., (2015) who has investigated the influence of 20 week aerobic exercise training on emotional stress reactivity in students experiencing real life examination stress and the article by Kim et al., (2013) who has explored the impact of Kouk Sun Do, a mind-based intervention on students with anxiety symptoms. This appraisal is important to determine its applicability for the case scenario of Mariana who is an Australian University student with a 18 month year daughter. Being a single mother, she lacks social support and has additional liabilities in her life compared to other students. This condition along with diabetes and rare blood disorder has made her very depressed in life. The critical appraisal and evaluation of the research paper is important for evidence based practice and choosing health intervention according to best available evidence (Grove et al., 2014). This report analyse the two papers to determi ne the best evidence based practice that can be applied in case of Mariana to relieve her from depressive symptoms. Critical Appraisal Paper 1 Author and the research method-The first research study conducted by von Haaren et al., (2015) is a randomized controlled study to investigate the impact of aerobic exercise training (AET) on engineering students. The randomized study design was based in recruiting 61 engineering students and they were randomly assigned to AET group and control group. It utilized ambulatory assessment technique to analyse psychological variables in real time and information related to this was maintained in a diary. Heirarchy of evidence- According to the hierarchy of classification of evidence based data, the article by von Haaren et al., (2015) comes under NHMRC level II category of evidence (NHMRC,.2009)and JBI places it under level 1c of experimental studies (The JBI Approach | JBI., 2016).In terms of S5 and S6 model of evidence, randomized study design is regarded as an unfiltered piece of information which in the bottom level of S6 evidence as it is a published journal (Dicenso et al., 2016) Abstract, purpose and ethics- The research was done with proper ethical consideration as all participants were informed about the purpose of study and written informed consent was taken from all participants. The abstract of the research article briefly summarizes the objective, methods and results of the research study. It helps in getting a brief idea of the research process as it mentioned that cardiopulmonary testing before and after AET intervention was done on all participants to determine the impact of emotional stress reactivity on sample. The conclusion from the research was also established by stating that AET intervention was effective in improving emotional stress reactivity (von Haaren et al., 2015). The purpose of the research became clear with the statement that current research on association between exercise and emotional stress reactivity has many limitations. Hence, the analysis of the study showed that the data are consistent with limitations discussed and the res ults obtained (Vaismoradi et al., 2013). Method and design-In the randomized controlled study, participant were classified into control group and intervention group according to their physical activity levels. Before the AET intervention, all participants received cardiopulmonary pre-test and the same was done post-intervention. One of the strength of the study design is the consideration of time in students life when they experience stress in real life. This was a commendable step as first assessment was done before the exam period when students had low stress and the final assessment was done after exam period when students face maximum stress. All the parctipants received AET intervention the intensity of which was slowly increased. The method employed for the research study is useful as data was analyzed statistically with all the parameters to determine the efficacy of intervention on improving stress response. Limitation and conclusion- The researcher concludes the article by explaining the outcome of the study and it applicability in current practice. It also gave scope for further research by stating that severity of stress should be investigated at different fitness level and at different stress conditions in life (von Haaren et al., 2015). This fact is also supported by Asmundson et al., (2013) who showed that exercise is a promising intervention to treat patients with anxiety disorders. Strength and weakness- One of the strength of the research design is the use of ambulatory assessment which assessed both psychological and emotional response to investigate the impact of aerobic exercise on reducing stress and the weakness is the small sample size which makes the reliability of research findings difficult for generalized population. Applicability- The aerobic exercise based intervention can be applied in the case of Marian to reduce stress as this is cost effective approach which Mariana can easily include in her daily life routine. Critical Appraisal of Paper 2: In the second paper by Kim et al., (2013), the authors have investigated about the effect of practicing Kouk Sun, in order to improve the mental health condition of the body and improve the level of stress response. In the research design technique the researchers have used the pilot technique and selected random technique to select the student of university. This is a special form of pilot study technique, which comes under the category of the unfiltered evidence of information that is according to the evidence of S5 hierarchy. The original journal was published with the rule of 6S hierarchy of evidence. With the help of the NHMRC level of evidence it is possible to classify this study according to the JBI evidencing level (The JBI Approach, 2016). The Kouk Sun Do practice originated in Korea, which is one of the most popular form of mind-body training and in this research prepare, the authors have aimed to explore the positive effect of this training upon the university students. According to Llapa et al., (2015), the Kouk Sun Do technique had been quite useful and effective in the past. However, in the modern context the effectiveness this technique is yet to be approved. In the present days, the meditation is one of the best forms of treatment that helps to deal with the excess pressure and tension (McGuigan, Sime Wallace, 2012). The Qigong exercise form has proved to be highly effective for the mind training and control the breathing pattern. The Kouk Sun Do can be more effective so as it uses the combination of various forms of exercise. With the help of these techniques it is possible to maintain both physical and mental health of an individual. The investigators with the help of proper ethical rules collected data from students, who are suffering from the stress and anxiety related symptoms. 18 of the students were asked to follow the principles of Kouk Sun Do (KSD) technique. The other 11 students were in the control group. The first group had used the KSD for 70 minutes sessions three times every week for a period of four weeks. With the help of parameters such as depression, copping skills and self-efficacy, the outcomes of the sessions were evaluated. The surveyors also used questionnaires techniques to collect information from the students and thus compare the results of both the group. This had helped them to access the effectiveness of the KSD technique compare to other forms of mind training exercise. In the result section the authors have mentioned about the techniques and that it showed the effectiveness of KSD to cure the depression is much more compared to other forms of mind training exercise. Hence, the researchers had concluded that the principles of KSD can be used in practice. However, there are also wide ranges of scope for the improvement of this research work. The main strength of this research work is that it has helped to identify the usefulness of KSD techniques. Nevertheless, as the sample size of the research was small, it was not possible for the investigators to provide a strong support for their statement. Hence, the limited sample size is the main weakness of this research work. Justification for Best Technique in the Scenario In the given case scenario, Mariana is a single mother, who got little support from the family and thus, it is crucial for her to get an appropriate intervention techniques. It is also important that the intervention techniques must be easy for her to follow in the daily life. Hence, it can be said that the KSD techniques that is mentioned in the second article is best for her, which will help her to deal with the stress and tension of her daily life. With the help of the different techniques that is used in the KSD it is possible for Mariana to maintain well-being of both her mental and physical health. On the other hand, with the help of the aerobic exercise that is mentioned in the first article, it is not possible to keep a healthy mental state. According to Abbott et al., (2016), it is not possible to achieve a good physical health only with the help of physical exercise as the physical state of well-being is related to the mental condition of a human being. The mental stress an d tension can cause damage to the memory and cognitive function of an individual. The KSD is has proved highly effective to act as functional repairmen of the body and enhance the power to concentrate on every day activities. The neuron mechanism of the body can also be improved with the help of this technique. (Alderman et al., 2016), believes that with the help of the combination of both medication and mind training exercise, along with the measures to intervene of physical fitness training, it is possible for an individual to overcome all the major health related hazards. Thus, for Mariana it is possible to have a healthy form of life by overcoming all forms of physical and mental health issues. With the help of the evidence that is provided in the paper of Kim et al., (2013) it can be said Mariana can easily overcome all forms of health obligations by adopting the practice of KSD and improve the overall quality of health and minimize the effects of stress and tension. Conclusion The report summarized the effect of two interventions- the aerobic exercise and the effect of Kouk Sun Do to determine its benefits on patients with depressive symptoms in life. The comparison and critical analysis of both literature revealed that both are effective intervention as the results demonstrated improvement in stress response and anxiety symptoms on patients. However, in relation to the applicability of the evidence based practice in case of Marians, it suggests that the second intervention, Kouk Sun Do can be more effective in reducing stress in Marianas life. This is supported by other research which showed that combination of physical and meditative exercise is useful in treating patients with depression (de Bruin et al., 2016). Reference Abbott, R.A., Whear, R., Rodgers, L.R., Bethel, A., Coon, J.T., Kuyken, W., Stein, K. and Dickens, C., 2014. Effectiveness of mindfulness-based stress reduction and mindfulness based cognitive therapy in vascular disease: a systematic review and meta-analysis of randomised controlled trials.Journal of psychosomatic research,76(5), pp.341-351. Alderman, B. L., Olson, R. L., Brush, C. J., Shors, T. J. (2016). 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