Critical Appraisal and Evaluation Evidence

Critical Appraisal and Evaluation Evidence
Blom et al., (2012) conducted a research to investigate the effects of using mindfulness mediation and Yoga to reduce stress, one of the causal agents of hypertension. The research is a valid random control trial, which subjected the subjects to randomized assignments without knowledge of their hypertensive conditions. The random assignment was first concealed from the participants taking part in the first study. The subjects were immediately randomized to receive MBSR or to receive the treatment after a wait-line control period. According to the research findings, it is not clear whether the randomized group received information on why they did not complete the research. The 12 week study duration selected was not enough to assess the effectiveness of the intervention plan. Despite this weakness in the research, all subjects were analyzed within the group they were randomized. The instruments used to measure the outcome were valid, and the subjects had similar clinical characteristics, making them fit for the study. The results showed that MBSR was an effective treatment method, and based on my patients, I believe that the findings will be helpful in reducing blood pressure among patients with uncontrolled hypertension. Since all clinically important outcomes were measured, I believe that my patients and families will have a positive reaction towards reducing hypertension in the society. There are higher expectations of speedy recovery among patients with uncontrolled hypertension.
Rose (2012), conducted an evidence-based systematic review on the effectiveness of Yoga in reducing blood pressure. Yoga is a form of relaxation and meditation technique, which is common among the orients, but has slowed been integrated in the western cultures. One of the attributes of the research is that valid and credible databases were used to find past studies on the effectiveness of Yoga. In fact, the researcher used MEDLINE, CINAHL, Academic Search Premier, and OVID to search for literature from past research dealing with the same information. The study explains that validity of the research was assessed to prevent biased arguments and to investigate whether there were errors in the primary research. Some of the methods used were randomized control trials, quasi-experimental studies and pilot studies. Similarly, the results were consistent in all the studies conducted and the individual patient data incorporated into the final results.
The results from the study demonstrated that not only does Yoga reduce high blood pressure, but also reduce blood glucose level and cholesterol levels. Based on these findings, the research will help in addressing my patients` conditions, since most Americans are affected by increased weight, high cholesterol in the blood and high blood glucose. The research investigated all clinically important outcomes, therefore providing me with great opportunities to address complications among my patients. Due to the dynamic outcomes and wide benefits of Yoga, my patients and family are optimistic that hypertension and other chronic diseases will be successfully dealt with.
Nolan et al., (2012) conducted a research to investigate whether behavioral interventions would reduce blood pressure among hypertensive patients. The research used randomized control trial, at which the subjects were subjected to randomized control trials without knowing about their hypertensive conditions. The sample size was significantly enough to conduct valid research, since it assessed the outcome from 65 patients. The control group was treated using antihypertensive drugs and in a research period of two months, the outcomes were compared.
The subjects were assessed on a six-1 hour session over a period of 2 months, and the outcomes analyzed using linear mixed models. The research methodology and analysis techniques were valid, making the findings to be reliable and applicable in future research. According to the findings, behavioral neurocardiac training demonstrated a daytime and 24-hour systolic BP reduction by โˆ’2.4+-0.9 mm Hg, P=0.009, and โˆ’2.1+-0.9 mm Hg, P=0.03, respectively. The controls outcome was insignificant, showing that the treatment option was very effective in reducing blood pressure as compared to standardized care. The research findings will be very helpful in addressing issues affecting my patients. The research conditions were similar to those being experienced by my patients and I believe that the findings will significantly help in ensuring that hypertensive patients are subjected to meditation and exercises as part of the treatment strategy. My family and patients are likely to be elated by these findings, because they provide hope for speedy recovery without using antihypertensive drugs.
The article by Debbie, et al (2011) is relevant to the research since it elaborates on the importance of using exercise and meditation to lower blood pressure. The article attempts to investigate the contribution of meditation through Yoga towards reducing blood pressure among patient with hypertension. The research, which was conducted by Debbie, LeAnne, Rand and John among others, addresses the issues raised in this research paper, and elaborates on the strengths and weaknesses in the primary research.
This research was retrieved from Pub Med, one of the valid databases for medical information. To generate the required information, the authors used a randomized control trial for 12 weeks to assess whether there were improvements in the patients conditions when using Yoga as compared to results generated by using the enhanced usual care. The purpose of the study was to investigate the effects of using Yoga as a treatment tool for hypertension and as a way of reducing blood pressure. The randomized control trial used 26 patients for the Yoga exercise, while the controlled group consisted of 31 patients, who were taken through the normal treatment procedure.
According to the research findings, the effects of Yoga took longer, but were equally effective as in the use of enhanced treatment options. After 6-12 weeks, there were insignificant changes, but after this trial period, Yoga subjects registered a significant drop in blood pressure and consequently a reduction in hypertension. The systolic, diastolic and mean arterial pressure dropped significantly in both treatment procedures, but they were more sustained when using Yoga that when using enhanced treatment options. Based on the study, the findings are valid and can be useful in the treatment of my patients, who have similar conditions.
The research by Siebenhofer, Jeitler, Berghold, Waltering, and Hemkens is relevant to the research question, since it attempts to explain how dieting can reduce blood pressure among hypersensitive patients. According to the authors, hypertension has many treatment methods and the bio-behavioral treatment options have specific benefits on the patients, since its not only long-term oriented, but also addresses some of the issues causing hypertension. The main objective of the authors in this research is to investigate the effects of using weight reducing drugs in the treatment of hypertension and as a way of reducing high blood pressure among the patients. In addition, the researched was aimed at investigating the effects of using weight reducing diet to the baseline blood pressure among hypersensitive patients.
The research is a systematic review, which is available at Pub Med database, one of the largest medical databases in the world. In addition to the systematic review, the research also incorporated Randomized control trials in its selection criteria to enhance the validity of information and to reduce chances of biasness. Using treatment duration of 6-36 months, the researches ensured that all patients were included into the treatment formula, and using a fixed-effect meta- analysis, the authors eliminated any chance of biasness and ensured that the information retrieved was accurate and useful for other associated researches. Although the samples were few, there was a significant reduction in blood pressure among hypersensitive patients. This information is therefore important in generating treatment options for hypersensitive patients in future.
References
Blom, K., How, M., Dai, M., Bake, B., Irvine, J., & Abbey, S. (2012). Hypertension Analysis of stress Reduction using Mindfulness meditation and Yoga (The HARMONY Study): study protocol of a randomized control trial. BMJ Open, 2 (2), 1.
Debbie, L. C., LeAnne, T. B., Rand, L. R., & John, T. F. (2011). Iyengar Yoga versus Enhanced Usual Care on Blood Pressure in Patients with Prehypertension to Stage I Hypertension: a Randomized Controlled Trial. Evidence-Based Complementary and Alternative Medicine, 2011 (1), 1-8.
Nolan, R. P., Floras, J. S., Harvey, P. J., Kamath, M. V., & Picton, P. E. (2010). Behavioral Neurocardiac Training in Hypertension: A Randomized, Controlled Trial. Hypertension, 55, 1033-1039.
Rose, O. N. (2012). Does Yoga Therapy Reduce Blood Pressure in Patients With Hypertension?: An Integrative Review. Holistic Nursing Practice, 26 (3), 137 – 141.
Siebenhofer, A., Jeitler, K., Berghold, A., Waltering, A., & Hemkens, L. G. (2011). Long-term effects of weight-reducing diets in hypertensive patients. Cochrane Database of Systematic Reviews, (9), 12-19.