research utilization paper

Research UtilizationAnna M. WheatleyFlorida Gulf Coast UniversityIntroductionBipolar disorder is a chronic mental health disorder that causes intense mood swings of depression and mania. Unfortunately, this disorder is commonly undiagnosed or misdiagnosed. This disabling disorder can diminish the patient’s quality of life; therefore, it is important this disorder is diagnosed properly. Unrecognized Bipolar Disorder in Patients With Depression Managed in Primary Care: A Systematic Review and Meta-Analysis is a quantitative research article that focuses on the percentage of primary care patients who are diagnosed with depression that have unrecognized bipolar disorder (Daveney, Panagioti, Waheed, & Esmail, 2019). Bipolar Disorder in Primary Care: A Qualitative Study of Clinician and Patient Experiences With Diagnosis and Treatment is a qualitative research article that focuses to understand the patients’ and clinicians’ experiences with diagnosis and treatment of the patients with bipolar disorder (Cerimele et al., 2019). To get a better understanding of this topic, it is beneficial to look at both of the quantitative and qualitive research to gain not only a statistical conclusion, but also an insightful understanding of the diagnosis and treatment of bipolar disorder. StructureFor both research articles chosen, the titles accurately describe each article. The accuracy of the titles allowed me the opportunity to quickly choose these articles as possible candidates to the related topic to critique. Based on the titles, I immediately reviewed the abstracts of the articles. Both abstracts were helpful, clear and relevant to the underdiagnoses and treatment plan of bipolar disorder. After reading both abstracts, it allowed me to appropriately choose both articles as my sources. In the abstracts were the purpose/objective statement. Both the quantitative and qualitative purposes were easy to understand and clear on what they aimed to cover in the articles and did not require extra research outside of what was stated in the abstract. The quantitative purpose statement made it clear that unrecognized bipolar disorder is common and intended to determine the percentage of patients with unrecognized bipolar disorder. The qualitative objective made it evident that the article aimed to understand the diagnoses and treatment experiences with the disorder. For both articles, the significance to nursing is implied due to the fact that understanding this research will impact nurses’ awareness on the topic. Literature ReviewThe literature review provides important information or a summary of previous research on a certain topic. In both of the quantitative and qualitative articles selected, I was able to get a specific and clear understanding of the topic and the connection between the articles and their supporting background evidence. Qualitative researchers Cerimele et al. (2019) emphasized that bipolar disorder causes a varying degree of symptoms that affect the quality of lives of the undiagnosed patients. They also identified the gap between the treatment received at a mental health clinic or hospital vs. the treatment received at primary care. Many patients report to primary care with symptoms relating to major depression, anxiety, or substance abuse; therefore, causing the patient to receive the wrong treatment. Quantitative researchers Daveney et al. (2019) highlighted the disabling depressive and manic affects the disorder causes, emphasizing the need for an accurate diagnosis to improve the quality of life of the patients. Their sources provided statistics to show the prevalence of the disorder in the population, the cost affects, and the unemployment rate due to the disorder. The researchers also identified a gap in the lack of current evidence of the unrecognized disorder in primary care patients with depression. For both articles, the evidence was current, and all sources were properly listed on the reference page. Framework/Sampling/EthicsFor the quantitative study on unrecognized bipolar disorder, it was a meta-analysis systematic review. The framework was not clearly identified. The researchers did not use a nursing theory/model; however, they used an analytical framework to explain the methods through which they developed the results. This goes hand in hand with their methodologies used to find their results. This framework provided a way for the researchers to organize what data to collect and how to analyze it. Their sampling method was choosing eligible prior research on the topic to systematically review. Their population of patients to review was adult patients diagnosed with depression with no history of bipolar disorder in primary care settings. They excluded general adult psychiatric care (non-primary care), studies involving children or adolescents, and grey literature (Daveney et al., 2019). It could have been strengthened using children and adolescents. They did not specify the IRB review or an informed consent process; however, a systematic review like this generally does not need ethics committee or institutional review board approval (Wormald & Evans, 2017). The qualitative study was exploratory, and the researchers used an inductive approach using thematic content analysis to identify themes in the data (Cerimele et al., 2019). This was clearly stated in their article and was consistent throughout their research. A nursing theory/model was not used. The researchers selected a sample population of a medical director, nursing director, and two patients from six different primary care clinics. The patients selected were chosen by clinicians based on having diagnoses of a complex mood disorder, bipolar disorder, or treatment-resistant depression (Cerimele et al., 2019). The study could have been strengthened using only bipolar disorder patients to get a better understanding of the treatment process of bipolar disorder specifically. The IRB process was not mentioned; however, the approval process and obtaining informed consent was confirmed. Both studies did not breach confidentiality. Data Collection/Methodology/ApplicationFor the quantitative article, the intricate meta-analysis systematic review using an analytical framework provided a way for the researchers to organize what data to collect and how to analyze it. This allowed the researchers to comb through data from several studies to find the most eligible, non-biased studies to review. Full-text screening allowed the researchers to conclude that 17% of patients treated for depression in primary care have unrecognized bipolar disorder (Daveney et al., 2019). In the exploratory qualitative study, using thematic content analysis to identify themes allowed the researchers to conclude the three themes of the diagnosis and treatment of bipolar disorder in primary care: detection of patients with bipolar disorder, referral to specialty care and medication treatment (Cerimele et al., 2019). Neither study involved a return of investment to any of the participating institutions; however, increasing awareness on proper treatment of bipolar disorder can save health care facilities money by cutting the expenses of unneeded treatment. A lot of money and resources are put into misdiagnoses. This can improve patient care dramatically by improving the quality of lives in these patients. Unrecognized bipolar disorders restrict patients from proper symptom management disabling them from the opportunities in life they could have if treated properly.ConclusionQuantitative and qualitative research methodologies both play an important role in EBP. Although qualitive research is insightful to the “how and “why” of a subject, I personally favor quantitative because I want to know the objective reality of the research. I prefer facts, numbers, and statistics to support my claims. I also favor it because as a future nurse I want to know concrete statistics to provide the best evidence-based practices for my patients. This would not only improve patient care, but also be more efficient to the facility I am employed to. ReferencesCerimele, J. M., Fortney, J. C., Pyne, J. M., & Curran, G. M. (2019). Bipolar disorder in primary care: a qualitative study of clinician and patient experiences with diagnosis and treatment. Family Practice, 36(1), 32–37. doi: 10.1093/fampra/cmy019Daveney, J., Panagioti, M., Waheed, W., & Esmail, A. (2019). Unrecognized bipolar disorder in patients with depression managed in primary care: a systematic review and meta-analysis. General Hospital Psychiatry, 58, 71–76. doi: 10.1016/j.genhosppsych.2019.03.006Wormald, R., & Evans, J. (2017). What makes systematic reviews systematic and why are they the highest level of evidence? Ophthalmic Epidemiology, 25(1), 27–30. doi: 10.1080/09286586.2017.1337913

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