NRS-433: Introduction to Nursing Research - Critique Assignment

This assignment is a research critique of two qualitative studies focused on the effects of exercise on the management of Type 2 Diabetes Mellitus (T2DM). The student analyzes two articles, examining their backgrounds, methods, results, and implications for nursing practice. The assignment begins with a PICO question and then delves into the clinical problems, significance, purposes, and research questions of the studies. The student compares and contrasts the methodologies used, highlighting the benefits and limitations of each. Key findings are summarized, and the implications for nursing care are discussed. Ethical considerations, such as plagiarism and the lack of information regarding research funding, are also addressed. The critique concludes by emphasizing the potential of exercise-based programs for T2DM management.

<Name>
Course: NRS- 433- Introduction to Nursing Research
<Date>
Instructor- Ellen Pavela, DNP, RN
Rough Draft-Qualitative Research Critique and Ethical Considerations
Type 2 diabetes, also referred to as adult onset diabetes, and is characterized by a sudden
increase in blood sugar level, due to relative absence of insulin or insulin resistance (Zheng, Ley
& Hu, 2018). The common symptoms of the condition are an increase in thirst, frequent
urination, unexplained loss of body weight, increased hunger, tiredness, fatigue, and ulcers. The
condition leads to cardiovascular problems, renal disease, vision problem, and limb amputation
as well. Since there is lack of evidence on effective non-pharmacological therapy that can help in
proper management of blood glucose level, two pieces of qualitative evidences have been
selected from the previous assignment that focuse on effects of exercise on diabetes
management. The PICO framework was used for development of the research question:
What are the impacts of exercise and physical activity on management of blood glucose among
patients diagnosed with type 2 Diabetes mellitus (T2DM)?
The article by Middleton (2018) will be designated as study 1 and that by Zanuso, Jimenez,
Pugliese, Corigliano and Balducci (2010) will be designated as study 2.
Background of Study
For study 1 the clinical problem is the importance of promoting physical activity for
bringing about positive health improvements among individuals suffering from diabetes. The
significance of the study is that it collects evidences from several pieces of scholarly work that
1

have been conducted by researchers, to evaluate the impact of prescribing a minimum limit of
exercise on glycemic control among patients. The purpose of the study is to determine the effects
of prescription of exercise for individuals diagnosed with T2DM (Middleton, 2018). The main
research question of is “what is the impact of prescription physical activity on glycemic index?”
For study 2 the clinical problem is the correlation between regular physical exercise and
glucose levels amid adolescence and children suffering from T2DM. The significance of the
study can be associated with the fact that it helps in determining the relation between regular
exercise and metabolic control of blood glucose levels (Zanuso, Jimenez, Pugliese, Corigliano &
Balducci, 2010). The purpose of the study was to evaluate the impact of regular physical exercise
and the research question was “Is participation in exercise activity beneficial to T2DM patients?”
Methods of Study
Qualitative research approach was used in both of the studies. Adoption of a qualitative
research design is primary exploratory that helps in gaining and understanding of opinions,
motivations, and reasons. A review was conducted in both the articles that focused on collection
of secondary data, critically appraising them, and synthesizing the findings in a qualitative
approach, thereby providing an exhaustive summary of updated evidences that are pertinent to
the research question. The author of the study did not incorporate articles that were published
prior to 2008 (Middleton, 2018). However, one major limitation can be associated with the fact
that there was lack of information on the methodology adopted for publishing this review, and
their search strategy that the researcher had implemented. The theoretical framework of this
particular article is based on phenomenology, since the articles that are included in the review are
based on first-person perception of the effect of exercise on T2DM (Evans-Agnew, Boutain &
Rosemberg, 2017).
2

In study 2, the age of literature supporting the article dates back to 1959, which can be
considered as a major drawback, since several new researches have been conducted over the
years which nullify the old evidences (Zanuso, Jimenez, Pugliese, Corigliano & Balducci, 2010).
This article was based on grounded theory approach that refers to a systematic methodology
encompassing construction of information through methodical data collection and analysis
(Evans-Agnew, Boutain & Rosemberg, 2017).
Results of Study
For the study 1 the results are published in one paragraph where it is stated that
prescription of exercise will act beneficial and as an adjunct to other interventions that would
encourage and enhance action and behaviour among diabetes patients, to show adherence to
behavioural modifications. The researchers also suggested that healthy eating motivation and
autonomous self-determined physical activity would enhance health outcomes among diabetes
patients, and help in self-management of the condition (Middleton, 2018). The results of this
study have implication for nursing care by increasing awareness and knowledge on the
effectiveness of prescribing exercise regimen. The results contribute change in nursing practice
by educating the nurses on the potential advantages of this non-pharmaceutical treatment
modality.
For study 2 the results state that combining resistance training with aerobic exercise will
help in glycemic control, and bring about a check in HbA1c levels. Hence, the researchers
suggested that combination of aerobic and resistance training would offer an incremental and
synergistic impact on glycaemic control among T2DM patients. The results of this study have
implication for nursing care by elucidating the mechanism of action of resistance based training,
thereby adding to nursing knowledge and expertise (Zanuso, Jimenez, Pugliese, Corigliano &
3

Balducci, 2010). The results contribute change in nursing practice by increasing awareness of the
nurses on the steps that must be followed for making patients show compliance to resistance
training. Accurately representing results of the cited articles was another major consideration.
Ethical Considerations
For study 1, there was no information about getting approval of the study from
investigational review board. Although no human participants were involved in the study, the
researchers failed to mention information about conflict of interest or plagiarism of data, in
relation to the articles that were used for the review (Middleton, 2018).
For study 2, the major ethical consideration was avoiding plagiarism of the previous
articles that were incorporated in the review (Zanuso, Jimenez, Pugliese, Corigliano & Balducci,
2010). In addition it is essential to provide adequate information about competing interests and
research funding, which was not done by the authors. There also lies the possibility of
incorporating published research that is fraudulent.
Conclusion
T2DM is a highly prevalent metabolic syndrome that is generally characterized by an
increase in blood glucose level due to insulin resistance. Although there are several known drugs
that help in keeping a check on blood glucose level, they are also found to exert potential adverse
effects on the health outcomes of patients. Therefore, exercise based programs can be considered
effective for T2DM management.
4

References
Evans-Agnew, R. A., Boutain, D. M., & Rosemberg, M. A. S. (2017). Advancing nursing
research in the visual era: Reenvisioning the photovoice process across
phenomenological, grounded theory, and critical theory methodologies. Advances in
Nursing Science, 40(1), E1-E15. doi: 10.1097/ANS.0000000000000159
Middleton, R. (2018). 'Prescription'of exercise for people with diabetes. Australian Nursing and
Midwifery Journal, 25(8), 32-32. Retrieved from
https://search.proquest.com/openview/96526a0d5aa792558cbce10f171ebf7c/1?pq-
origsite=gscholar&cbl=33490
Zanuso, S., Jimenez, A., Pugliese, G., Corigliano, G., & Balducci, S. (2010). Exercise for the
management of type 2 diabetes: a review of the evidence. Acta diabetologica, 47(1), 15-
22. DOI 10.1007/s00592-009-0126-3
Zheng, Y., Ley, S. H., & Hu, F. B. (2018). Global aetiology and epidemiology of type 2 diabetes
mellitus and its complications. Nature Reviews Endocrinology, 14(2), 88.
https://doi.org/10.1038/nrendo.2017.151
5