Mediyoga as an Alternative Management for Paroxysmal Atrial Fibrillation

Research Article Critique
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Introduction
An article critique is designed to evaluate the details of the article to understand if the bases and hypotheses are valid and testable for the latter and comprehend the applicability of the results of the study. In this paper, we shall critique Wahlström et al.’s (2019) research paper entitled, “MediYoga as a part of a self-management programme among patients with paroxysmal atrial fibrillation – a randomized study.” Generally, the article supports MediYoga as an alternative management for the said disease and can be used as an adjunct self-management intervention. This paper reviews the abstract, introduction, methodology, results, discussion, and implications in advanced practice nursing and future research projects.
Appropriateness of the Title
Based on the PICOT format, the study’s title was incomplete and gave a vague clue about its study design. The persons of interest (P) are patients with paroxysmal atrial fibrillation, the intervention (I) is MediYoga, there is no explicit comparison (C), the outcome (O) is the effectiveness of MediYoga as a self-management program, and the time frame (T) was not also mentioned. It contains three critical elements of a PICOT question that must be evident as the reader goes through the title. Moreover, the title contains “a randomized study,” which only pertains to randomization and does not point out a controlled trial. This is critical since there are studies where the participants were randomized, but the circumstances were uncontrolled (Polit & Beck, 2010).
Review of the Abstract
The abstract provided a brief overview of the whole study. It was complete, containing a brief introduction, a methodology that includes the number of participants, a results section that briefly discussed the data from the Short-Form Health Survey, and other factors such as the diastolic blood pressure (DBP), heart rate (HR), and N-terminal proB-type natriuretic peptide (NT-proBNP) levels (Wahlström et al., 2019). The brief introduction only explained two concepts, including paroxysmal atrial fibrillation and yoga. However, there is no mention of the knowledge gap, which will help establish a proper objective of the study (Polit & Beck, 2010). Nevertheless, the other parts were accurate, and the presentation of the information was organized and easily understandable.
Review of the Introduction
Problem Statement
The problem statement can be found at the beginning of the paragraph, explaining paroxysmal atrial fibrillations, their implications, and associated factors. Specifically, the issue was directed to the challenges the patients suffer from their condition, including its adverse effects on their livelihood (Wahlström et al., 2019). This statement was concise and coherent, and the reader can readily identify the root cause of the problem. It drove the paper’s agenda and instigated its significance.
Healthcare providers are invested in finding the answer to the problem highlighted for its potential in improving the lives of patients suffering from paroxysmal atrial fibrillation. It also included the knowledge gap based on the Cochrane review on the current arguments about yoga’s effectiveness and why it is necessary to evaluate MediYoga as an adjunct treatment (Wahlström et al., 2019). The authors were able to correctly identify the problem and establish the concern about the results of the previous studies, which were all due to the lack of randomization. Hence, there is a need to do a randomized trial to make the results of this study generalizable (Polit & Beck, 2010).
Purpose
The study aimed to investigate the efficiency of MediYoga as an adjunct for the self-management of paroxysmal atrial fibrillation. The authors were able to concisely identify the factors that would reflect its effectiveness, including the health-related quality of life (HRQoL), BP, NT-proBNP, and HR (Wahlström et al., 2019). The aim of the study followed the guideline in making a worthy goal: 1) Specific. The aim was specific to the welfare of patients with paroxysmal atrial fibrillation; 2) Measurable. The aim utilized quantitative outcome measures.; 3) Relevant. The study is relevant based on the existing research gap. However, it cannot be noted whether the aim was attainable as the authors did not state the timeline in the objective. However, it was stated in the methodology.
Research Questions
The researchers did not directly state the research questions in the paper. However, this can be indirectly noted by examining the title and matching it with the objective. Therefore, the study asks, “What is the impact of MediYoga (I) to patients with paroxysmal atrial fibrillation (P) compared to standard therapy or relaxation (C), on their HRQoL, BP, HR, and NT-proBNP (O) in 12 weeks (T)?” (Wahlström et al., 2019).
Hypotheses and Null Hypotheses
The study’s alternative hypothesis is that MediYoga is an effective adjunct self-management intervention against paroxysmal atrial fibrillation. Conversely, its null hypothesis is that MediYoga does not have any advantage over not having any adjunct self-management intervention in treating paroxysmal atrial fibrillation. These were evident in the introduction and objective of the study because the aim was to investigate the effectiveness and the alternative hypothesis that can be identified as the result that made a difference between two strategies, namely, MediYoga and standard therapy or relaxation.
Review of Literature Review
The review of the literature was not directly stated in the paper. However, we can review it by analyzing the introduction part, which is based on sound research. Notably, the information was gathered from research articles, and peer-reviewed journals even published some with high ratings in terms of validity and reliability. Aside from this, the information from these journals was related to the topic and helped define various terms and enumerate several factors related to paroxysmal atrial fibrillation.
Peer-reviewed journals may or may not be considered primary sources. Some are considered secondary sources because the primary data and results were gathered by a different researcher other than the one who made the synthesis (Polit & Beck, 2010). The study utilized secondary sources that resemble a literature review like the meta-analysis published by Kodama et al. and Cramer et al. (Wahlström et al., 2019).
The main problem was that the research papers used were not all updated, and some were even highly outdated (i.e., 20 years or more of publication). Review of literature must include recent journals published within five years to ensure that the knowledge gap is updated and recent studies do not yet address the factors that will be considered. However, the most probable reason why the researchers used outdated sources is that there are areas of research that do not have a solid foundation based on research studies.
As highlighted by the literature reviews, the significant gap that made the other reach on the topic is that they were all not randomized, hence not providing adequate representation of the total population suffering from the condition. The literature review addresses this and other issues that had hindered the adoption of the pertinent information on the topic (Wahlström et al., 2019). However, the paper’s authors acknowledge the hard work conducted by their colleagues and quote some of the findings they obtain as applicable in testing their hypothesis. The author indicated the development of the review in natural and straightforward language that simplifies the understanding of the concepts identified to the target audience. The audience is provided with a meticulously sorted review that provides logical information concerning the topic at hand (Wahlström et al., 2019).
The objective is clear and direct to any reader who comes across the study. The needs of the study are correctly addressed, making the information tailored to satisfy the objective intended. Additionally, the authors utilized the searched literature to summarize the evidence that applies to the clinical setting and provided a conclusion about the gap in knowledge by stating the lack of randomized controlled trials and the small sample size of the present studies in the Cochrane review concerning the effects of yoga (Wahlström et al., 2019).
Review of the Conceptual Framework
The study contains a conceptual framework that highlights the main concepts, internal and external factors, variables, and presumptions and associations. These areas were accurately described and helped construct the study design (Wahlström et al., 2019). Specifically, the conceptual framework guides the reader from the introduction, where the authors readily introduced the target participants of the study, who are patients with paroxysmal atrial fibrillation, and the concepts related to it. The presentation was commendable as it was concise and coherent. Additionally, in the dev...