Evidence Based Practice Research

This essay critically analyzes a research paper on foot care for people with rheumatoid arthritis. It examines the research process, methodology, and types of research available to clinicians. The essay also discusses the relevancy of the paper to clinical practices and explores the importance of systematic review and meta-analysis in evidence-based research.

EVIDENVE BASED
PRACTICE AND
RESEARCH METHOD

Table of Contents
INTRODUCTION...........................................................................................................................1
MAIN BODY ..................................................................................................................................1
Discuss research process within research paper.....................................................................1
Methods and methodology used within this paper.................................................................3
Types of research available to a clinician and relevancy of this paper with clinical practices6
CONCLUSION ...............................................................................................................................9
REFERENCES..............................................................................................................................10

INTRODUCTION
Evidence based practice is the explicit, conscientious and judicious usage of evidences in
making a decision regarding care of individual patients. It is associated patient value, clinical
exercise and best research evidence so that appropriate decisions in respect with patients
condition can be taken. Rheumatoid arthritis is referred to a progressive, disabling autoimmune
and long term disease. It is caused due to inflammation, pain in and near joints and
inflammation. This disease usually impacts hands and feet first but passes on to joints. Different
symptoms of this illness are stiff joints, fatigues and unwell feeling. This disease impacts the
entire body of an individual, other than feet and hands, it impacts lungs, heart and eyes also. This
research is based on “A quantitative study of foot care for people with rheumatoid arthritis.”
This research is carried out to explore the experiences of patients related with foot
problems due to rheumatoid arthritis. It will involve onset of symptoms along with foot health
interventions. This particular article for critique is chosen to resolve the issues and difficulties
faced by the patients of rheumatoid arthritis in a desired manner (Genovese and et. Al, 2016).
This research is conducted to find evidences regarding arthritis and associated foot symptoms so
that so that patients can be treated in a proper way. From researcher's perspective, this research is
carried out so that clinical practices related with rheumatoid arthritis can be further improved.
This will benefits in conducting future practices and researches regarding this topic in a desired
manner.
With the help of secondary research, this specific research paper is selected for critique.
Out of all the desired topics, this particular topic is selected because now a days it is a major
concern which is faced by large population. Findings and study on this research paper will also
acknowledged with the help of secondary resources such as books, journals, internet, other
online sources etc.
MAIN BODY
Discuss research process within research paper
Research process is referred as the systematic procedure in a systematic inquiry. Either a
research is short or long term, applying methodologies helps in saving time and generate better
outcomes. It is a multiple step process in which steps are interlinked to each other. Changes
carried out in one step will impacts the findings of another step. Research process associated
1

with quantitative study of foot care for rheumatoid arthritis patients includes some specific steps
which are mentioned below:
 Identification of problem: First step related with research process is identification of
problem or development of research questions. This research problem can either be some
information or knowledge which is required by general practitioner or clinical agency.
Problem that is identified in this research paper is foot care issues for people with
rheumatoid arthritis, which is a common concern within community these days. This
topic will serves as focus of study (Kaur, White and Bartold, 2013).
 Review the literature: After identification of problem, researcher is required to learn
more aspects about investigating topic. In this regard, researcher is needed to review
different literatures related with research problem. For this research paper, literature
review is carried out on topics like significance of foot symptoms in relation to diagnosis
of rheumatoid arthritis, knowledge and issues about foot symptoms and effectiveness of
foot health interventions. It will helps in recognizing future consequences of rheumatoid
arthritis.
 Clarifying the problem: In this step, the researcher clarifies the problem or issue in a
desired way so that scope of study can be narrowed. In this regard, study on people with
rheumatoid arthritis will be a broad concept, to carry out research properly, this issue is
clarified and scope of study is narrowed to conduct a study regarding foot care for people
with rheumatoid arthritis.
 Clearly defining terms and concepts: To perform research desirably, it is essential that
terms and concepts related with research will be clear. In order to avoid confusion, the
researcher is require to define important concepts and terms in a proper manner. In
accordance with this research paper, important terms like foot care, rheumatoid arthritis,
clinical practice etc. needs to be defined in a proper way. This will helps in carrying out
study in a proper manner.
 Defining the population: Generally, research focuses on specific population rather than
a large number of people. If the considered population will be big in size, then it will
became difficult for researcher to carry out research properly. Participants of this research
are purposely recruited. People which are more than 18 years, confirms diagnosis of
2

rheumatoid arthritis, experience foot issues, foot orthoses and foot surgery are considered
as participants.
 Developmental of instrumental plan: Plan associated with research or study is called as
instrumental plan. It serves as a roadmap for entire study where people for research are
chosen from National Rheumatoid Arthritis society, present in England. This study can
not include entire population which is above 18 years and face foot issues due to arthritis.
For this research, 25 people which met inclusion criteria are chosen.
 Collection of data: Main research study began with data collection. It is a critical step
that provided needed information for potential research questions. These data can be
collected either by primary or secondary data collection technique (Kourilovitch,
Galarza-Maldonado, and Ortiz-Prado, 2014). For this specific research paper, 22
participants agreed and data is collected with the help of focus group. To collect data,
formal informed consent of participant is taken and they were provided with the option to
withdraw anytime.
 Analysis of data: All the previous steps of research process are carried out to reach this
final stage. At this step, the researcher has data so that research questions can be
answered desirably. In this particular study, researcher has use thematic data analysis. To
enhance its credibility, data is reviewed and coded, themes are discussed and codes are
converted into themes. In this way, a result will be carried out for this study with the help
of findings and evidence.
Methods and methodology used within this paper
Methodology
Methodology is a theoretical and systematic analysis of those methods which is applied
to the field of study. It includes theoretical analysis of different methods and principles which are
associated with branch of knowledge. It will helps the researcher in understanding which
methods, practice or set of methods can be implemented to a particular case.
For this study which is related with foot care for people associated with rheumatoid
arthritis, qualitative methodology is used along with interpretive approach. This will helps in
collecting data and performing analysis in a desired manner. It will involve different experiences
faced by participants along with previous knowledge of researcher related with study. Under
qualitative methodology, focus groups are chosen as data collection method. Distinct features
3

and characteristics of this method are social interaction, group synergy and dynamics that helps
in acknowledging the richness of data. Researcher is planning to prepare three or four groups
consisting six to eight members. Having this number of participants will be sufficient to achieve
the required aims and objectives associated with study (Kumar, 2019).
Flaws, biases and variables identified in chosen methods
For this research, focus group method is chosen to collect data from participants or
respondents in a desired manner. These are a part of qualitative market research which is
designed to be informative in nature. There are some flaws in this chosen method some of these
are mentioned below:
 Focus groups are quite expensive in comparison with other types of research. For this
research, there are more than 20 participants which means that carrying out focus group
method will be very costly for researcher.
 They have limited number of respondents and questions due to which limited knowledge
can be acknowledged within a specific time period.
There is no biasses with this particular method but moderator or researcher can do biasses
by manipulating the opinion of respondents. This can be done by telling them to be opt a social
choice which favours the opinion of researcher. In this research no biasses takes place and every
aspect is carried out in a transparent manner. In general, there are two kinds of variable i.e.
dependent and independent variables. In this research paper, no dependent or independent
variable is identified.
Identification of any variables which are not mentioned by author
Variable is an entity which defines anything that has a quality or quantity. Researchers
are usually interested in dependent variable whereas an independent variable impacts the
dependent variable in a desired manner (Mackey and Gass, 2015). There is some identified
variable which have not mentioned by author. For example, “To identify best treatment to
overcome foot care issue for people with rheumatoid arthritis.” In this aim, the dependent
variable is rheumatoid arthritis whereas independent variable is best therapy. It is acknowledged
because main interest of researcher is on the disease i.e. rheumatoid arthritis. This makes it as a
dependent variable. Whereas treatment to overcome this disease is independent variable as
researcher has no interest in that but to complete research in a desired manner, it is essential to
consider that variable also.
4

Ways to address these variables
Interest of researcher is on dependent variable which is rheumatoid arthritis as the entire
research is based on those patients which requires foot care due to this disease. But independent
variable in this aim is best treatment. This treatment posses a considerable impact on dependent
variable i.e. rheumatoid arthritis as it is a measure to resolve the issues and difficulties which are
faced by the patients due to arthritis. Rheumatoid arthritis is an inflammatory chronic disorder
which can impacts joints, foot, hands, eyes, heart etc. of an individual. This situation takes place
when immune system of an individual attracts own body tissues rather than external viruses and
bacteria. Symptoms associated with this disease are warm, swollen and tender joints. Beside it,
joint stiffness can be faced due to inactivity (Silverman, 2016). Other symptoms are loss of
appetite, fatigue and fever. But there are some measures and therapies which can help in
overcoming these problems. One of the best treatment in this regard is DMARDs. It is not a
permanent cure for this problem but remission of symptoms will take place DMARDs
medication is given to patient. This drug has the potential to slow down the progression of the
concerned disease and can prevent joints and other tissues form permanent damage. DMARDs
stand for disease modifying anti-rheumatic drugs. Common elements in these drugs are
methotrexate, leflunomide, hydroxychloroquine, sulfasalazine etc. These compounds benefits the
patients in getting relief from the foot pain caused by rheumatoid arthritis. But there are some
side effects of this treatment which can be severe as liver damage, severe lung infection or bone
marrow suppression. These side-effects can risks the life of an individual if not given proper
consideration (Alvesson and Sköldberg, 2017). Other treatment in this regard are steroids such
as prednisone which helps in reducing inflammation and pain in joints. Also, it prevents damage
to the joints because of the disease. But it can results in thinning of bones, diabetes and weight
gain if medication will not suit the patient in a proper way.
Alternative method to eradicate this variable and biases
There are some methods by which biasses and negative variable can be removed from the
research. In this regard, the researcher can use questionnaire to collect data and information
rather than using focus group method. Questionnaire is a method in which a set of questions is
prepared which have multiple choices. Random people out of total population are choose to fill
this questionnaire and their answers will be considered as the opinion of entire population. With
the help of questionnaire, respondents will be able to choose those options which are relevant
5

according to their knowledge. In this way, there will be no chances of biasses and research will
takes place in an appropriate manner.
Types of research available to a clinician and relevancy of this paper with clinical practices
Research are the paper and scholars which are written by the professionals of their
specific fields. There are various types of research available to write which depends upon the
nature of researcher and research. Evidence based research are the research which provides
proper evidence of their findings within their scholar paper. The evidence based practice are the
research areas such as medical, laws etc. (Brannen, 2017). All of these areas requires a lot of
evidence to prove their argument. There are two types of research available for the researcher
such as qualitative and quantitative. Qualitative research is based on the quality of research i.e.
this type of research is based on providing the evidence on the basis of theories and frameworks.
This types of research always plans to provide a quality. Another research is based on
quantitative types of research. In this method, a lot of statistics and documents are used to
provide evidence to their arguments. This type of research is based on the quantity of statistics
and documents.
In case of evidence based practice qualitative research is included. This type of research
uses various types of theories and frameworks which allow the researcher to provide evidence to
its arguments. Quality of the research always is the priority in such type. Apart from that, this
also help the researcher to understand the reason, opinion and motivation of doing the research.
It emphasis in getting into the issue deeper to solve the problem effectively. This type of data
collection method uses individual interviews, group discussion and participation.
In order to access the evidence in the medical field hierarchy of evidence is used. This
type of evidence provides effective help to the researcher to reach to the objectives. Following is
the diagram of hierarchy of evidence:
6

As per the above stated diagram, it can be determined that there are various levels of
evidence in the research. In the above diagram there are seven levels of strong evidence. Starting
from expert opinion and ending at meta analysis is the strongest evidence provided in the
research. To start from the lowest evidence, expert opinion sometimes can provide wrong
information. Since the expert is providing the information which is limited to itself and does not
have any type of evidence. The higher evidence is “case report” which is used within the case
study of a research. This stage has some of the evidence but does not allow it to be strong
enough. After that, case control studies are found in which case is controlled by an expert.
Therefore, it is providing the evidence with an expert advice (Hair and et. al., 2015). The
strongest level is still behind from this stage. Therefore the next stage is Cohort studies in which
a group of individuals are collected to provide a group discussion on Podiatric practice. This is
also not sufficient according to the hierarchy of evidence. After that randomized controlled trials
are used through which the researcher tries to collect the evidence randomly. Since random
evidence cannot provide strong defence to the data used within research, therefore another
milestone should have been reached such as Systematic review and Meta-analysis. Systematic
review is the answer of defined research question by collecting and summarizing all empirical
evidence that fits with the research. Apart from that meta-analysis is also used for providing the
evidence but for the statistical data. Therefore, it can be said that the strongest evidence produced
by the researcher is meta-analysis and systematic review. The presence of systematic review is
7

important for any research to be evidence based. Without having systematic review is not
possible to provide effective evidence to the data stated in the research. If the systematic review
is not included the value of the clinical research will also gets down. In clinical research, it is
quite important to have a strong evidence to the information provided. This evidence is collected
with the help of systematic review for the theories and frameworks. In this research where
qualitative method is sued. The value of systematic review also gets increased. Without the
systematic review it is quite impossible to provide equal value in the clinical practice.
The type of journal where a paper is published is important. Journals are the larger view
of literature which shows various type of articles related to it. These articles provides various
type of information related to that journal (Newton, 2016). Journal is broad concept in which
various type of articles are present related to it. In clinical research, a particular type of Journal is
published and there are a lot of articles related to that Journal will provide specific information.
This is why having the importance of a journal. Without having journals, it is quite difficult to
search about a particular type of articles.
Author of the paper is the person who writes its personal and literature views so as to
provide effective and new information. It is quite important to have the name of author on the
paper. Author provides its personal perception and other details also. Therefore it is necessary to
argue with the author about the represented information. Apart from that, any writer who wants
to continue the research also requires to gain the previous knowledge about the research which
can be gained by meeting with the author. Therefore it is necessary for the paper to have name of
author.
There are various needs and requirement available for the research paper, article and
journal to be published. After writing the article it is quite important for the researcher to identify
the correct Journal to publish the report (Patten, 2017). In order to do that, the aims, objectives
and availability and performance of the Journal is required. This will help the researcher to
identify the perfect Journal and publishing the paper. The author of the research paper always
influence the judgement of the research. A research having proper named with author always
considered to be acceptable as it has the responsible write which is providing the clinical
information.
8

CONCLUSION
From above carried out research, it has been concluded that research process helps in
understanding research paper in a desired manner. There are some steps in research process
which are required to be followed so that research can takes place in a proper way (Roberts,
2013). Qualitative method is an useful methodology to carry out a research. Under this
methodology, focus group is chosen as data collection method. But there are some biasses and
flaws in this method (Laschinger, Johnson and Kohr, 2016). To overcome it, researcher can use
questionnaire. This will help in performing research activities desirably. Evidence based practice
requires hierarchy of evidence in which systematic review and meta-analysis is the most strong
evidence a researcher can applied in to its research. Apart from that, value of Journal and articles
also help in identifying the ways of publishing the articles.
9

REFERENCES
Books and Journals
Alvesson, M. and Sköldberg, K., 2017. Reflexive methodology: New vistas for qualitative
research. Sage.
Brannen, J., 2017. Mixing methods: Qualitative and quantitative research. Routledge.
Genovese, M. C. And et. Al, 2016. Baricitinib in patients with refractory rheumatoid arthritis.
New England Journal of Medicine. 374(13). pp.1243-1252.
Hair and et. al., 2015. Essentials of business research methods. Routledge.
Kaur, S., White, S. and Bartold, P. M., 2013. Periodontal disease and rheumatoid arthritis: a
systematic review. Journal of dental research. 92(5). pp.399-408.
Kourilovitch, M., Galarza-Maldonado, C. and Ortiz-Prado, E., 2014. Diagnosis and classification
of rheumatoid arthritis. Journal of autoimmunity. 48. pp.26-30.
Kumar, R., 2019. Research methodology: A step-by-step guide for beginners. Sage Publications
Limited.
Laschinger, H. S., Johnson, G. and Kohr, R., 2016. Building undergraduate nursing students'
knowledge of the research process in nursing. Journal of Nursing Education. 29(3).
pp.114-117.
Mackey, A. and Gass, S. M., 2015. Second language research: Methodology and design.
Routledge.
Newton, P. and Burgess, D., 2016. Exploring types of educational action research: Implications
for research validity. In The Best Available Evidence (pp. 33-46). Brill Sense.
Patten, M. L. and Newhart, M., 2017. Understanding research methods: An overview of the
essentials. Routledge.
Roberts, H. ed., 2013. Doing feminist research. Routledge.
Silverman, D. ed., 2016. Qualitative research. Sage.
10