Critically Appraising Qualitative Studies about Mindfulness-based Cognitive Therapy and Depression.Critically appraising is an essential aspect that should be incorporated within practice to further develop evidence-based when providing care to service users. This essay will critically appraise two qualitative research studies; (Mason and Hargreaves, 2001) ‘A qualitative study of mindfulness-based cognitive therapy for depression’ and (Smith, Graham and Senthinathan, 2006) ‘Mindfulness-based cognitive therapy for recurring depression in older people: a qualitative study’. Both studies selected will be analysed using ‘Critical Appraisal skill Programme’ (CASP) tool. CASP is a checklist that covers three major areas including validity, reliability and transferability. It has helped develop an evidence-based approach in the NHS (Sekiguchi and Kawamori, 2003). Individually, the studies discuss and evaluate the effectiveness of Mindfulness-Based Cognitive Therapy in individuals diagnosed with depression. Use of MCBT as an intervention for re-occurring depressive disorder reduce relapse from 78% to 36% in fifty-five patients with three or more previous episodes (Helen and Teasdale 2004). MCBT was identified as a cost-effective intervention in treatment of re-occurring depression (Smith and Graham 2006). Major Depressive Disorder (MDD) is a long-term condition that has high prevalence and frequent relapse and recurrence which amplifies MDD’s significance in Public Health (Vittengl et al., 2007). The risk of relapse–recurrence is increased by 18% in people who recover from a Major Depressive Episode (MDE), 85% of people who recovered from MDE, experience a second MDE within 15 years of naturalistic follow-up (Mueller et al., 1999). Designed to reduce recurrence of relapse in people with unipolar major depression, MCBT a meditation-based intervention (Smith and Graham 2006). Unique interventions are available in combating MDD, these interventions include MCBT. Increase risk for relapse/ recurrence of depression is caused by dysphoria-activated depressive thinking, MCBT is a group-based intervention designed to empower patients to self-manage prodromal symptoms allied with MDD (Segal, 2010). mindfulness-based cognitive therapy for people who are currently well but have experienced three or more previous episodes of depression. (NICE, 2011)Evidence-based Practice (EBP) is the integration of the best research evidence with clinical expertise and the patient’s unique circumstances. EBP empowers nurses with knowledge from research literatures to make significant amount of judgements and clinical decisions when providing patients with personal-centred and high-quality care. Role of the nurse is providing high-quality and cost-effective health care to patients. To make correct and appropriate decisions, understanding of the pyramid of evidence and their reliability is paramount. (Rebecca 2016). Due to pressure from healthcare facilities to adopt a more consumer savvy treatment and care options for service users, cost containment and greater availability of information, use of EBP gain momentum and was adopted into care. EBP demands changes in training of student nurses, closer working between other clinicians and researchers lead to more practice-relevant research and increase in the quality of care provided to patients. EBP provided nurses with opportunity to maximizes the level of clinical judgement and improve the level of care provided to a more streamlined, personal-cantered, more effective, and more dynamic. Due to EBP providing nurses with knowledge about latest technological advances and takes advantage of new knowledge developments, EBP is used to define best practice rather than supporting existing practices. (Youngblut and Brooten 2001). Hierarchy of nursing research provides a systematic outline from the least reliable to the most reliable source of evidence. Different types of evidence include; starting from the base are ideas, opinions, anecdotes and editorials, cases-controlled studies, case series and case reports, cohort studies, Randomised Control trials, critically-appraised individual articles, critically appraised topics and finally at the apex of the pyramid is systematic reviews and meta-analysis. The pyramid of evidence in Nursing constitute both qualitative and quantitative forms. According to Taylor & Bogdan, 1984, qualitative research is rooted in a phenomenological paradigm which holds that reality is socially constructed through individual or collective definitions of the situation. Research into the effectiveness of MCBT as a group-based intervention is recently just emerging, MCBT has been identified as a cost-effective intervention for Major Depressive Disorder. Evidence about MCBT has accumulated in recent years, however, due to scarce studies being available about MCBT there is still lack of knowledge about effectiveness of MCBT in older adults. (Smith and Graham 2006).Smith, Graham and Senthinathan, 2006 conducted a qualitative study about effectiveness of MCBT for recurring depression in older people. The abstract summarised the aims for the outcome of the research and a brief outline of the recruitment process and assessment process. The introduction explained the rationale behind the focus of the study and gave insight into the background of MCBT, it also highlighted the history of MCBT and cited previous done research and highlighted the importance of the MCBT. the title of the study is self-explanatory about the study. 35 participants who are aged over 65 were recruited, 30 participants completed the MCBT course.
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