Critical Appraisal Report: CASP Guidelines for Research Evaluation

This report presents a critical appraisal of two research articles using the CASP (Critical Appraisal Skills Programme) guidelines. The first article investigates the effectiveness of individualised interventions for constipation in nursing home residents, evaluating study validity, results, and usefulness. The report examines the research questions, methodology (including randomised trials and participant allocation), and the treatment effects. The second article, though briefly mentioned, focuses on families' experiences with anticipatory loss. The report follows CASP's structured approach, assessing bias, results analysis, and the applicability of findings, offering a comprehensive evaluation of the research's strengths and limitations, and its relevance to healthcare practices. The analysis considers factors like participant involvement, reference adequacy, and the equality of treatment groups, providing a detailed review for evidence-based practice.

CRITICAL APPRAISAL

TABLE OF CONTENTS
CASP GUIDELINES.......................................................................................................................3
INTRODUCTION ARTICLE 1......................................................................................................3
Effectiveness of individualised intervention on older residents with constipation in nursing
home.......................................................................................................................................3
Review....................................................................................................................................4
INTRODUCTION ARTICLE 2......................................................................................................6
The experiences of families living with the anticipatory loss of a school-age child with spinal
muscular atrophy – the parents’ perspective..........................................................................6
Review....................................................................................................................................6
COMPARISON...............................................................................................................................9
REFERENCES..............................................................................................................................10

CASP GUIDELINES
This is the method which is being used by the researcher in order to find the evidence of his
or her research based on the judgement. There are three results that are being taken under this
method, that are as follows:
Study validity?
It is the first stage of the research of the CASP. This is the study where researcher is
being identified that weather his or her research is biased or not. In this methodology quality is
being identified. Different criteria have been founded related to the evaluation of the article.
Different question is being identified that are treatment, diagnosis, prognosis and economic
evaluation.
What are the results?
In this stage it has been decided that study is being valid or not and the researcher move
to analyse the all the results which have been included in the article. Different experiment is
being done to find that result are appropriate or not. It is very for the researcher to find that the
results are proper or not. With that uncertainty have also being founded to analyse that what are
different gaps between the actual data and standard one.
Usefulness of the results?
Once it has been founded that all the results are relevant and important then the
researcher need to apply the different questions such as patient or population may have different
characteristics to those in the study. It can be said that CASP model is very important method
which helps the analyse all the results in proper manner.
INTRODUCTION
Paper 1
Effectiveness of individualised intervention on older residents with a constipation in nursing
home is an article which is being presented by various authors. It has been noticed that key
outcome in terms of study is being evaluated in terms of nursing home. Classification of key
authors can be as Huang, T., Yang, D., Tsai, Y. and Tsay, P.K. It has been noticed that by having
an effective consideration of paper the development in terms of individualised intervention is

necessary to refer so that decrease in constipation among older adults can be taken into account.
Also, the nursing homes working in regard to treatment of such health issues are also being
referred properly.
Review
Did study asked clear questions?
Yes, study has effectively focused on the research questions in order to provide effective
development of measures. It has clearly indicated the purpose regarding identification of nursing
facilities in context to constipation. According to detailed study of the article, it can be said that
number of authors and experts has worked together in collective manner. For effective
consideration of diverse values in terms of nursing home facility the issues can be resolved. In
addition to this, it can be said that the article is being presented with a motive to have
development and examine the effectiveness of individualised to reduce constipation among older
adults in the nursing homes. It has been noticed that key information about the subject is
properly presented within study. In addition to this, it can be said that questionnaire is being
designed in order to ask questions to the participants so that better outcome can be attained.
Along with this, application of key norms in terms of questionnaire theory is being employed
properly so that goals and objectives can be accomplished.
The study aimed to assess the effectiveness of health education programme conducted by
nurses to analyse the facilities in respect to constipation. Detailed explanation in descriptive
manner about the issue is not being presented which indicates that overall outcome can be
influenced in diverse manner. In addition to this, it can be said that appropriate learning in
respect to constipation is being referred properly so that goals and objectives can be
accomplished. Proper structuring of the report is also being provided in order to have sustainable
development. In background it has been noticed that long term facilities advancement within
health care is also beneficial for sustainable development. It has also been presented in the initial
background that 60-80 percent of residents are facing an issue in terms of constipation. Overall
information about the symptoms and side effects is also being presented in the article such as
haemorrhoids, faecal impaction, intestinal bleeding. By offering such kind of information the
issue has been discussed in standardised manner.
Was randomised trial was appropriate?

Application of random sampling and further values is also appropriate in order to have
sustainable development. By having an application of key measures in terms of methodology the
issues are being discussed so that better values can be taken into account. Yes the application of
testing the treatment process was properly referred in the study. It has provided an appropriate
learning in regard to nursing practice. By having an appropriate consideration of key symptoms
of constipation the issues can be resolved. Qualitative approach is referred as systematic
approach through which key measures can be taken into account. Random sampling approach
and theory is being used by the experts in order to ensure that appropriate standards are being
followed. In addition to this, key values in terms of random selection is also being taken into
account so that appropriate collection is being taken into account.
Along with this, it has been noticed that the article is also effectively focused towards
methodology selection in order to have better application of key standards. A prospective,
randomised control is referred as practice which is being employed by researcher in context to
northern Taiwan. In this, graphs and other descriptive information is being presented so that
better outcome can be taken into account. In addition to this, it has been noticed that random
sampling is a method which is also being referred by experts in order to ensure that data
collection is being accomplished properly. Moreover, systematic approach is being taken into
account for effective accomplishment of measures. Quantitative aspects are also being referred to
meet the outcome of the study.
Were participants allocated to intervention and control groups?
All the groups and individuals has been focused on the effective participation in the
study. With an application of diverse measures the issues are being discussed properly. In this
work it was realistic for nurses providing the intervention to be to the study in justified manner.
It has been noticed that generally the participants does not accept the respondent’s selection
properly due to diverse factors. It order to attract participants properly the communication theory
is being employed. It has created better awareness and attracted to have effective allocation to
intervention and control groups.
According to detailed study of the article, it can be said that number of authors and
experts has worked together in collective manner. For effective consideration of diverse values in
terms of nursing home facility the issues can be resolved. In addition to this, it can be said that
the article is being presented with a motive to have development and examine the effectiveness

of individualised to reduce constipation among older adults in the nursing homes. It has been
noticed that key information about the subject is properly presented within study. Detailed
explanation in descriptive manner about the issue is not being presented which indicates that
overall outcome can be influenced in diverse manner. In addition to this, it can be said that
appropriate learning in respect to constipation is being referred properly so that goals and
objectives can be accomplished. Proper structuring of the report is also being provided in order
to have sustainable development. In background it has been noticed that long term facilities
advancement within health care is also beneficial for sustainable development. It has also been
presented in the initial background that 60-80 percent of residents are facing an issue in terms of
constipation. Overall information about the symptoms and side effects is also being presented in
the article such as haemorrhoids, faecal impaction, intestinal bleeding. By offering such kind of
information the issue has been discussed in standardised manner.
Were all participants involved in conclusion?
Yes all the participants has effectively involved in the interpretation process of
conclusion. It has provided efficient outcome and ensure that key values in terms of study.
However, full application of intention to treat can only be performed where there is complete
outcome data for all randomised subjects. In this respect, the conclusion is being taken into
account with a help of thematic theory. It has allowed to collect information in appropriate
manner so that conclusion can be framed effectively.
The research has been conducted in field of constipation and the various factors are come
out after conduction of research and investigation work in field related to constipation. The
constipation is one of the vital topic and the certain theories and research has been conducted in
that favour and the certain issues are come out in that regard. It also explained that how the
certain factors create an awareness among people and also made contribution under community.
The so many people are affected because of constipation, the specialists conduct long research to
identify down the conditions and issues which causes constipation. The every individual will
experience down the constipation at some point. The scientists and specialists emphasises on the
molecular process, physiological process and also made testing under that so that constipation
will be control and also discuss about the various therapies that are to be bring which is
essentially important for the people who suffered from such disorders. The various medicine and
drugs are been tested and after completing the successful research such drug will be bring which

helps down people and helps them to fight with constipation. The management of constipation
among the various patients under the nursing homes is very challenging for the patients and
health care staff and it is generally not a severe disease but it describes the difficulties that person
has to faced down during bowel movements. It will be increase with the increasing age and the
people who above 70 years is generally suffered from the constipation diseases.
Did participants have enough references?
Yes proper sources are being accessed in order to have evaluation of methods so that key
outcome can be attained. It has been noticed that participants has considered diverse sources in
context to constipation so that key measures can be taken into account.
In addition to this, it can be said that results of study has presented that participants in the
experimental group had a significant change in the defection. It has been noticed that
advancement in frequency and bowel sounds are being compared with the control group. It
means the there is not much difference in the constipation symptoms, Bristol stool form and
laxatives. It has also been noticed that by having an improved focus on the individualised to
intervention may be appropriate for decreasing constipation among nursing home residents. It
will also motivate the further researchers to have effective development of key values in terms of
sustainability.
Aside from the experimental intervention, were the groups treated equally?
Yes, all the groups were treated equally. In this regard, it can be said that key outcome in
respect to experimental values are being referred properly. Application of measures in terms of
constipation treatment is being referred. Changes in diet habits is also a practice which might
create a better sustainability. Equality act is being considered by the experts in order to ensure
that all groups are being treated equally. All respondents has been allowed to have appropriate
participation in ethical manner. Government norms are being followed in terms to meet the
quality standards.
How large was the treatment effect?
Yes but at the time of Initially there are some issues are faced and process is too long. It
indicates that the treatment process takes more time which impacts the overall outcome in
diverse manner. Application of standards is significant to refer for better accomplishment of
treatment.

How precise was the estimate of the treatment effect?
Yes, it has served huge advantages such as it have removed the constipation problems of
the patients and improve the quality of life of the people. However, if participants and assessors
were not blinded to their randomisation status, they might provide an answer to
please assessors or the tone of assessors might subconsciously bias participants
Can the results be applied in the context?
Yes, it can be applied in the same context. The research also explain women are more
suffered as compared to me and the constipation can because due to bad digestive system, due to
contaminated water, physiological factors, loss in appetite and so on and it will be a temporary
disease and it will be disappeared according to the time. The certain factors are investigated in
that regard and the specialists taken certain steps in order to controlled such problems and also
creating an awareness among people and they also launched down certain instruments which will
be helpful for the individual to assess down the problem related to constipation and they also said
that it is important for the individual to raise their standards. The resident assessment instrument
for the long term care facilities is need to be standardised, validated and these certain factors help
down individual in assessing their health conditions.
Were all clinically important outcomes
No, some points are missing and all the points were not considered properly. The aim of
this system is to review and assess down the factors related to non-pharmacological therapies for
the patients with functional constipation. The various studies have been made in that regard to
controlled down such factors and these systems also helps down the clinical in taking down
decision in field of clinical practice and also helps down various patients who seeking from
functional constipation by providing better treatment options to them so which helps them to
controlled their constipation. The main objective behind this research and study to create an
awareness among the people who generally suffers from the constipation. Clinical psychology is
an integration of science, theory and clinical knowledge for the purpose of understanding,
preventing, and relieving psychologically based distress or dysfunction and to promote
subjective well-being and personal development. It has provided a support to ensure that
outcome are being accomplished with consideration of standards.

Are the benefits worth the harms and costs?
Yes, all the people have gained the advantaged from the outcomes
INTRODUCTION
The experience of the families living with the anticipatory loss of a school age child with
spinal muscular atrophy with the parent's perspective by Bao-Juan Yang Phd, RN, Pei-Fan Mu
Phd, RN and Wen-Sheng Wang Phd. The key aim of this article is to the enquiry into parent's
anticipatory loss of the school age children with the Type 1 and 11 spinal atrophy.
Paper 2
The experiences of families living with the anticipatory loss of a school-age child with spinal
muscular atrophy – the parents’ perspective
Did the trial address a clearly focused issue?
The issue was to address the information and understanding about the Spinal muscular
atrophy to the people of country, parents and the nurses so that problem can be solves. Yes the
trail have address a clearly focused issue.
Spinal muscular atrophy is the genetic disease which have very great impact over the part of
nervous system of the human body that which controls the voluntary muscle movement. It is
being known that most of the nerve cell that have control over the muscles are being located in
the spinal cord. When it is concerned about this disease then it occurs in the spinal cord which
control muscles. Thus, it can be said that this disease is muscular, this is because it has direct
impacted over the muscles of the human body. The biggest cause of this disease is the person
does not able to receive any signals from their nerve cells. Spinal muscular atrophy involves the
loss of nerve cells called motor neurons in the spinal cord and is classified as a motor neuron
disease (Arias, 2011). There are several reasons that can cause Spinal muscular atrophy which
may also called as non-chromosome 5. The first cause which is find in the spinal muscular
atrophy is weakness in the Muscles. The muscles which are more close to the centre parts of the
body such as shoulders, hips, thighs and upper back. These parts start swelling and result in
abnormalities in these functions. New theory have been applied to Treat Spinal muscular atrophy
Tested in the Laboratory. It has been worked in the laboratory of the Matthew E. R. Butchbach at
the Nemours Alfred I. Du Pont Hospital for Children in Wilmington, Delaware. They have
reserached that system biology can be used in order to solve the problem which helps to increase

the SMN level of the treatment. They have stated that SMN2 can be increased when person is
suffering from the SMN 1 or vice versa.
Two types of Spinal muscular atrophy
There are two types of Spinal muscular atrophy that are Type 1 and type 2. When the
symptoms of Spinal muscular atrophy is being founded in the baby from their birth to the 6
months, then this is called as type 1 SMA. Generally babies have muscle weakness, a weak cry
and breathing distress. They often have difficulty swallowing and sucking, and don't reach the
developmental milestone of being able to sit up unassisted. On the other hand when the
symptoms is being founded in the child of 7 and 18 months and before the child can stand or
walk independently, then this is called as type 2 SMA.
Was the assignment of patients to treatments randomised?
Yes it has been randomised which helps to find the problems faced by the parents. It has
been founded that parents have to struggle lot with the loss of child due to Spinal muscular
atrophy. This is the disease which is commonly founded in the child. With that this disease need
to be taken cared properly so that they can reduce the risk of loss of child. It is very important to
generate awareness in the mind of parents regarding the SMA so they can have proper
knowledge about the disease and they can prevent their child from the disease. It has been
founded that people are not aware about the disease and this is the reason the disease is being
increasing day by day (Yang, Mu and Wang, 2016). It is very important for the country to create
about the disease. Child is the one who are future of the country and they need to be taken cured
so that they can develop the country. If these children feel weakness and have muscular problem,
then how can they build their future. Thus, parents need to take care of their child from their
birth so that they can build their child in such a way that their child can develop themselves.
It has been founded that parents have been feeling mentally and physically exhausted
because their child are not having muscular strength. And this is the reason there are several
crises that have been created in the families. It is very important for the parents to create the
awareness about the disease so that they can come out form the crises.
Were all the patients who entered were all the patients who entered conclusion?
Can't tell, it is not recognised by the article, In order to collect the information about the
parents that what they are feeling when their child are having Spinal muscular atrophy, primary

data have been collect. It is very important to collect the information regarding the same, this is
because parents need to aware that what different disease which can harm their child are. The
data is being collected from the 19 parents. The survey is being conducted in the Taiwan. The
sample size which is being selected in order to conduct the survey have the age of 32 to 49 years.
Interviews is being conducted where every individual is being asked some questions related to
the disease and what they feel for the child. The interview have been conducted on the basis of
anticipated loss that have occurred to the child and due to that loss, which crises and issues the
family members or parents are facing. Quantitative approach have been used in the doing the
research or analysing the collected data. It is the systematic approach by which key measures can
be taken to solve the problem. Systematic Random sampling approach and theory used by the
researcher in order to ensure that appropriate standards are being followed and data can be
collected and analysed properly.
Were patients, health workers and study personnel ‘blind’ to treatment?
Can't tell, this because it is can not be told from the article. It has been founded that there
are 10 consequences of Spinal muscular atrophy, that are confronting premature death, making
difficult treatment choices, fearing the loss of functional ability, coming to terms with lost
expectations, loss of sleep and stress, stigma, limitations on social activities, independence,
uncertainty and helplessness and family finances. It is very important for the parents to
understand it (Sandler, 2010). This because these all ten consequences is very bad for the child
and their families or may cause large number of crises in the family. Proper treatment theory
have been applied in this context which states that all the members are being treated fairly. No
bias nature can be involved in the treatment of any individual
Were the groups similar at the start of the trial?
Can't tell, this is because it was based on the different themes. There have been four
themes have created by the authors related to the Spinal muscular atrophy. The four that includes
in this research are enduring the helplessness and pressure of the care, suffering due to child
unknown and rare condition. Loss of home and reinforcement of the child and parents
attachment and removing the pressure of death and increasing the child life.
Aside from the experimental intervention, were the groups treated equally?

Can't tell, this is because, the group have not been created, rather themes have been made.
These themes help the people to have relevant information about the disease and hos people can
avoid the disease. It is very significant for the parents to have proper knowledge about the
subject so that they can take care of their child and avoid the symptoms of the Spinal muscular
atrophy. Other than that It is very important for the nurses to have proper knowledge about the
anticipated loss which the parents are facing for their school age child with the type 1 and type 2
Spinal muscular atrophy. If the nurse will have proper knowledge about the subject or disease
then they can able to take care of the child properly so that parents can nor feel problems or
crises in their families due to their children.
How large was the treatment effect?
The outcome of the research state that the research helps the nurses to enhance their skills
and knowledge to avoid and end the problems. They will able to know that what are the different
causes of the disease and how it can be removed from the roots so that coming generation will
not have and suffer from the disease. Other than that it have enhances or increased the
professional for the child care who can understand the problems which are faced by the
surrounding and society and needs and wants of the people from the child care.
How precise was the estimate of the treatment effect?
Don't know, very high level of burden on the families as well as on the parents of the child who
are suffering from the Spinal muscular atrophy. Other than that it can be said that it have creased
very high level of burden on the families as well as on the parents of the child who are suffering
from the Spinal muscular atrophy. It is very important step that need to be taken by the family in
order to find that what the child are facing due to SMA. The parents need to find in their new
born baby that weather they are having the different disease or not. This will help them to take
care of their new born baby till these baby develop themselves.
Can the results be applied in the context?
Yes, it can be applied in the same context, this is because the case are the same and this
can helps them to solve the problem related to the Spinal muscular atrophy. It has been noticed
that by having an actual information in regard to the spinal muscles the issues are being measures
in desired manner.