Write a critical appraisal that demonstrates comprehension of two qualitative research studies. Use the "Research Critique Guidelines – Part 1" document to organize your essay. Successful completion o

Write a critical appraisal that demonstrates comprehension of two qualitative research studies. Use the "Research Critique Guidelines – Part 1" document to organize your essay. Successful completion o 1

Literature Evaluation Table

Student Name:

Summary of Clinical Issue:

Effect of Exercise on the prevention of osteoporosis and associated fractures in high-risk individuals.

Clinical issues arise from the patient population who suffers from Osteoporosis

It's estimated that about 30 million American citizens have low bone density, do, they are in a high risk for low trauma fractures. Limitations of using bone mineral density alone for drug therapy decisions, absolute risk assessment, and evidence for the cost-effectiveness of the population therapy are presented.

With the aging of society, the prevention and treatment of osteoporosis have become a more recognized concern, the screening and the wide spreading of bone density development of efficacious therapies that increase bone density and reduce fracture risk have resulted in more patients being evaluated and managed for osteoporosis, we still having issues existing in clinical practice where guidance is lacking on appropriate management. Three clinical issues are frequently faced by clinical nurses for providing practice and giving guidance on how to approach the management of the osteoporosis-related problem.

The first issue is discussing the management of low bone and when to consider initialize pharmacologic therapy. The second issue is preventing and treatment of vitamin D deficiency in the elderly, and finally the third issue is how to manage a patient that is deemed a potential treatment failure, how to define treatment failure, common causes of treatment failures, and the approach to the management of the patient who is not responding to appropriate osteoporosis therapy treatment.

PICOT Question:

Criteria	Article 1	Article 2	Article 3
APA-Formatted Article Citation with Permalink	Gibbs JC, MacIntyre NJ, Ponzano M, et al. Exercise for improving outcomes after an osteoporotic vertebral fracture. Cochrane Database Syst Rev. 2019;7(7): CD008618. Published 2019 Jul 5. doi:10.1002/14651858.CD008618.pub	McArthur C, Laprade J, Giangregorio LM. Suggestions for Adapting Yoga to the Needs of Older Adults with Osteoporosis. J Altern Complement Med. 2016;22(3):223-226. DOI:10.1089/acm.2014.0397	Giangregorio LM, Papaioannou A, Macintyre NJ, et al. Too Fit Fracture: exercise recommendations for individuals with osteoporosis or osteoporotic vertebral fracture. Osteoporos Int. 2014;25(3):821-835. DOI:10.1007/s00198-013-2523-
How Does the Article Relate to the PICOT Question?	It gives an alternative on how to manage osteoporosis through doing exercise for improved outcomes after osteoporosis vertebral fracture.	It gives suggestions on adapting Yoga to the needs of older adults with osteoporosis.	Recommends individuals with osteoporosis or osteoporotic vertebral fracture to do more exercise.
Quantitative, Qualitative (How do you know?)	Qualitative is used to gain an understanding of underlying reasons, opinions, and motivations.	Qualitative also provide insights into the problem by developing ideas.	Qualitative respondents are selected to fulfill a given quota or area.
Purpose Statement	Explore the preference of elderly care regarding activity- related life space and life satisfaction.	Explore an understanding of risk factors and barriers to osteoporosis prevention and control.	Explore patient's perceptions of osteoporosis and treatment.
Research Question	What is the optimal care elderly with lower limb fractures from your experiences?	How are you measuring malnutrition in older people?	What is the risk of osteoporosis?
Outcome	Increase in bone stiffness.	Walking may preserve bone health in elderly women.	Increased height, improve functional performance.
Setting (Where did the study take place?)	Sweden	Turkey	Netherland
Sample	Women(50-65);n=50	Fracture patients screened at an osteoporosis screening clinic(30-90 YA;n=27)	Fracture patients with a previous BMD test(40-86;n=18)
Method	Interviews; general motor function assessment.	Group and individual interviews, participant observation, and analysis.	Interviews,inductive content analysis.
Key Findings of the Study	A third of patients accurately recounted test results.	Limited knowledge of osteoporosis.	Findings suggest a lack of trust in one's body and a negative view of aging.
Recommendations of the Researcher	Recommend regular weight-bearing and muscle-strengthening exercise to reduce the risk of falls and fractures.	Recommend BDM testing to those who have suffered a fracture to determine the degree of disease severity.	Initiate treatment in those with hip fractures.

Criteria	Article 4	Article 5	Article 6
APA-Formatted Article Citation with Permalink	Khan M, Cheung AM, Khan AA. Drug-Related Adverse Events of Osteoporosis Therapy. Endocrinol Metab Clin North Am. 2017;46(1):181-192. DOI:10.1016/j.ecl.2016.09.009	Khan AA, Morrison A, Hanley DA, et al. Diagnosis and management of osteonecrosis of the jaw: a systematic review and international consensus. J Bone Miner Res. 2015;30(1):3-23. DOI:10.1002/jbmr.2405	Little B, Koromani F, Brown JP, et al. The Radiology of Osteoporotic Vertebral Fractures Revisited. J Bone Miner Res. 2019;34(3):409-418. DOI:10.1002/jbmr.3669
How Does the Article Relate to the PICOT Question?	All talks about Drug-Related Adverse Events of Osteoporosis Therapy.	It relates to the Diagnosis and management of osteonecrosis of the jaw which is a systematic review and international consensus of the patients.	It suggests the Radiology of Osteoporotic Vertebral Fractures be Revisited.
Quantitative, Qualitative (How do you know?)	Quantitative is always used to quantify the problem by way of generating numerical data.	It's used to quantify attitudes, opinions, and other variables.	It uses measurable data to formulate facts and uncover patterns in research.
Purpose Statement	Understand how and why secondary fracture prevention services can be implemented.	Understanding patient and physician adherence issues of self-injectable osteoporosis medication.	Develop and explore internet-based fracture-risk intervention.
Research Question	Who is more likely to receive a bone mineral density test?	Who is more likely to engage in regular physical activity?	Who is more likely to use nutritional supplements known to facilitate healthy bone development?
Outcome	The decrease in urinary DPD.	Significant increase in femoral neck BMD.	Suggest a longer duration study to support findings.
Setting (Where did the study take place?)	Australia	UK	England
Sample	Osteoporosis patients(40-80 YA;n=22)	Healthcare professionals(n=43)	Females who experience vertebral fracture~9 years ago(56-70;n=6)
Method	Interviews; normalization process theory.	Interviews; focus groups; analyzed for themes and conceptual model development.	Mixed method randomized clinical trial: questionnaire; focus group; tutorial evaluation forms.
Key Findings of the Study	Many culturally specific misunderstandings and obstacles concerning osteoporosis prevention.	Patients understand osteoporosis but not medication and risk.	Motivation, physician messages, side effects, and clinical profile affected patients' adherence and persistence.
Recommendations of the Researcher	Check for secondary causes.	Advise avoidance of tobacco smoking and excessive alcohol intake.	In postmenopausal women and men age 50-70, recommend BMD testing.