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The negative is that family relationships begin to change, friendships change and losses occur. Retirement often means finding new meaning in life (Wheeler, 2014). 

I NEED A RESPONSE TO THIS ASSIGNMENT

2 REFERENCES

Week 11 Discussion Post

There are special considerations when working with older adults, as the psychosocial developmental process can be both positive and negative. The positive is that later years allow time for personal growth and development that were difficult when work and family responsibilities were priorities (Wheeler, 2014). The negative is that family relationships begin to change, friendships change and losses occur. Retirement often means finding new meaning in life (Wheeler, 2014).

During group therapy sessions with older adults, many of the members are diagnosed with depression. Depression is common among the elderly but is not a natural aspect of aging (Wheeler, 2014). Symptoms often include physical manifestations such as aches, pains, and gastrointestinal problems and cognitive symptoms such as changes in sleep, appetite, and use of pain medication (Wheeler, 2014). One of the main issues that have presented itself during our group sessions is participation resistance. Some of the elderly members are reluctant to share and are withdrawn.

Techniques by the facilitator include a variety of ways to encourage participation. While this may seem silly, one of these techniques is to play Jenga. Each member of the group takes turns grabbing a wood piece from the stack without causing the stack to fall. Once they successfully grab a piece, the facilitator asks a question such as, “what is one of your greatest accomplishments” or “what is one stressor or situation you have overcome in your life”. This encourages participation without putting group members on the spot. This also promotes cohesiveness among group members as they’re working together toward a common goal. Other techniques by the facilitator include art therapy, worksheets, and vision boards. One challenge that may arise is members who blatantly refuse to participate. When this occurs, the facilitator should encourage participation without being forceful. For example, “Joe, we’d love to have you join us in this activity but we understand if you’re not feeling up to it today.” While strategies may vary, several studies have concluded that cognitive behavioral therapy is effective in older adults with depression (Krishna et al., 2012) (Krishna et al., 2010).

References

Krishna, M., Honagodu, A., Rajendra, R., Sundarachar, R., Lane, S., & Lepping, P. (2012). A systematic review and meta-analysis of group psychotherapy for sub-clinical depression in older adults. International Journal of Geriatric Psychiatry28(9), 881–888. https://doi.org/10.1002/gps.3905

Krishna, M., Jauhari, A., Lepping, P., Turner, J., Crossley, D., & Krishnamoorthy, A. (2010). Is group psychotherapy effective in older adults with depression? a systematic review. International Journal of Geriatric Psychiatry26(4), 331–340. https://doi.org/10.1002/gps.2546

Wheeler, K. (2014). Psychotherapy for the Advanced Practice Psychiatric Nurse (2nd ed.). Springer Publishing Company, LLC.

Statistical significance can also be used to achieve positive outcomes by analyzing the variability of subjects and the magnitude of effect on the patients during the research (Physical Therapy, 2014).

reply1

Clinical significance can be defined as the magnitude of the actual treatment effect which will determine whether the results of the trial are likely to impact current medical practice. Statistical significance on the other hand quantifies the probability of a study’s results being due to chance (Ranganathan, Pramesh, & Buyse, 2015). In clinical practice, the clinical significance of a result is dependent on its implications on existing practice. The clinical significance should reflect the extent of change, whether the change makes a real difference, how long the effect lasts, cost effectiveness and ease of implementation. Unlike statistical significance that has established traditionally accepted values; clinical significance is often based on the judgment of the health care provider and the patient.

Statistical significance is majorly dependent on the study’s sample size; even with large sample sizes, small treatment effects can appear statistically significant and therefore the analyzer has to interpret carefully whether the significance is clinically meaningful. Statistical significance can be used to support positive outcomes in the EBP project by medical practitioners ensuring examination of the research outcomes in or. der to come up with the clinical significance. Several measures can be used to determine the clinical relevance required, confidence intervals and magnitude-based inferencesStatistical significance can also be used to achieve positive outcomes by analyzing the variability of subjects and the magnitude of effect on the patients during the research (Physical Therapy, 2014).

References

Physical Therapy, I. S. (2014). Beyond Statistical Significance: Clinical Interpretation of Rehabilitation Research Literature. International Journal of Sports Physical Therapy, 9(5), 726-736.

Ranganathan, P., Pramesh, C., & Buyse, M. (2015). Common Pitfalls in Statistical Analysis: Clinical versus Statistical Significance. Perspectives in Clinical research, 6(3), 169-170.

reply2

Clinical significance is defined as the practical value of an effect of treatment regardless of whether it has a real genuine, palpable, or noticeable effect on our everyday lives. Clinical significance reflects the impact on clinical practice. Statistical significance simply measures how probable any evident differences in outcome between control groups and treatment are. Statistical significance indicates the reliability of the study results. Clinically significant result occurs when medical experts believe that the finding is considered medically crucial and applied as a provision of care to patients. Clinical significance may help to validate whether a treatment effect has practical importance and if it has a real effect on daily life.

Since most statistically significant results are of clinical importance, it means that for a project to achieve positive outcomes, one must apply statistical significance. When the results are reliable, they can be applied to clinical significance. When the p-value value is positive, it means that it is not rejected; hence, the results will result in the projects achieving positive outcomes when applied to clinical significance. Although clinical significance is usually a subjective evaluation and cannot be established by a single experiential test, statistical significance must always be determined before determination of clinical significance in evidence based research practice.

I will be able to support positive outcomes and prove clinical significance of my project by ensuring that the results of decrease in 30 day readmission rates is statistically significant.

Heavey, E.(2015). Differentiating statistical significance and clinical significance. American Nurse Today, 10(5): 26-28. Retrieved from https://www.brockport.edu/daily_eagle/doc/2015-04/item_8038_7659.pdf

Sedgwick, P. (2014). Clinical significance versus Statistical Significance. BMJ, 348(mar14 11), g2130-g2130. doi: http://dx.doi.org/10.1136/bmj.g2130