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Qualitative article
The qualitative research methodology underlines the issue of the lack of relevant findings in the field of nicotine replacement therapy in people and the necessity of treatment, especially in the early stages of implementation. Such an approach falls under the contiguity of the philosophical perspective of recognizing vulnerable populations with psychotic disorders and the applied methodology (Page 6, paragraph 3, sentence 1). The objective of the following analysis aims to refine an existing smoking cessation intervention for the populations with mental disorders. The qualitative methodology, which implies open discussions and conversational communication with the research subjects, supports the objective (Wilson et al., 2019). It helps identify the best promising treatment based on theoretical treatment models, developing the procedures, and collecting data while providing intervention (Wilson et al., 2019). Thus, the research question opens fully with the support of relevant methodology (P3; p1; s1). The data collection methods enhance the qualitative research methodology as it is based on an inductive, data-focused approach that preludes hypothesis testing (Wilson et al., 2019). A cohort design is specifically applied to ensure proper data collection in sustaining qualitative intervention (P7; p2; s2).
The interpretation of results is performed at the end of each cohort to analyze the data from participant interviews and app utilization. The weekly staff meetings, combined with qualitative methodology, allowed for careful interpretation of the outcomes and tailoring of the treatment (P14; p4; s6). Moreover, the research was purely scientific and was based on numerical data, so there was no evidence of researchers’ cultural or theoretical prejudice. The research does not underline the researchers’ and patients’ cultural background, which could have affected the experiment outcomes. The researchers’ personal views did not seem to have affected the outcomes other than pure recommendations from study therapists’ notes for the program improvement (P25; p2; s2). The participants’ data, on the other hand, are fully included through contingency management (P37; RC; p5; s2). Feedback for different cohorts also included a range of results from app usage neglect (P20; p2; s3) to troubles in smoking abstinence (P20; p2; s4).
The research can be considered ethical by the modern standards as the researches showed significant consideration for their subject through considerate therapists adapting to the needs of the patients (P18; p2; s8) and constant encouragement via text messages (P18; p2; s5). The conclusions state the necessary steps to be taken to achieve the proper level of nicotine replacement therapy combined with psychotherapy based on the evidence from research (P26; p1; s4).
Randomized Controlled Trial
The research question was formed narrow enough to have only a limited number of trials conducted. The provided research states of being a quasi-randomized trial due to the difference in patient’s ability to stay under researchers’ supervision and have individual sessions (P269; RC; p3; s2). However, the initial division in the ‘Rethink your Smoking’ program (RSP) or minimal intervention (MI) groups was randomized among the patients who agreed to participate (P269; RC; p3; s1). The baseline for admission in both groups was the age requirement of full 18 years, a diagnosis of substance use disorder (SUD) with no relevance to the assigned group, and tobacco usage with a score ≥ 1 on the Fagerstrom Test of Nicotine Dependence (FTND) (P269; RC; p5; s2) (Rüther et al., 2016). The participants’ background and demographic factors were also analyzed and provided in table 2 (P272).
It is not clear whether the allocation to treatment groups was concealed at the moment of the trial, but the research discloses that they were receiving therapy at the Department of Psychiatry and Psychotherapy at Ludwig Maximilian University in Munich (P269; RC; p2; s1). However, some part of the trial and the feedback was received in a telephone interview (P269; RC; p3; s8). Both the assessors and the participants were aware of the treatment. The outcomes assessors were the instructors who implemented the treatment and analyzed the data accordingly (P269; RC; p3; s10). The tobacco treatment was clear to the participants as both groups had sessions about the issue of nicotine addiction and were provided with Nicorette ® TX patch, gum, and lozenge (NRT) with extensive instructions (P269; RC; p3; s3-4). Both groups were treated accordingly, respectful of their wish, as the participation was voluntary. The study focuses on the available additional individual psychotherapy sessions for the RSP group (P270; LC; p1; s3) and extra advice if wanted for the MI group (P270; LC; p2; s3).
The outcomes were based purely on statistical evidence for both groups in the same way separately and together (P272; LC; p1; s2). They are reliable and appropriate for a small-scale trial as the statistics for both groups are compared to each other based on a mathematical equation (P272; LC; p1; s3). The study also provides follow-up research three months after the program (P273; LC; p3; s1). The statistical data of reduction in the FTND score is provided and compared in both groups (P273; LC; p3; s2).
Systematic Quantitative Review
The review question is stated clearly and explicitly to explore patient care principles for patients with SUD (P1; p2; s1). The inclusion criteria followed the classic Arksey and O’Malley framework to cover the breadth of the existing evidence in the first stage (P2; RC; p4; s2) and eligibility criteria in the second stage (P3; LC; p1; s2) (Marchand, 2019). The search strategy is appropriate for the topic as it frames the population with substance-related disorders, the concept of patient-centered care, and the context of healthcare settings for delivering substance use disorder treatment (P2; RC; p4; s2). The sources for the review were Medline, Embase, and so forth (P2; RC; p5; s3) for empirical evidence and British Columbia Guidelines and Protocols Databases, CPG Infobase, and so forth (P2; RC; p5; s4) for grey literature, which are reliable medical databases.
The criteria for appraising studies were appropriate as the direct content analysis was based on the Patient-centered care (PCC) principles that were evaluated (P3; LC; p4; s2). The research was conducted by two independent researchers (author KM and SB) (P2; RC; p6; s1). There were no methods applied to minimize possible mistakes in the review, but the content subject to the team review for trustworthiness (P3; RC; p2; s1).
The review was created as a combination of multiple studies through a reliable systematic method applied to coding to determine the content’s patterns and relationships (P3; LC; p4; s3). The publication does not appear to be biased as the two researchers create an agreement scale for each decision in the review (P3; LC; p1; s2), and the team checks specific data in the analysis (P3; RC; p2; s1) to keep the study unbiased. The recommendations for improvement and integration of Patient-centered care are based on particular personal background domains and are supported by the provided research (P11; RC; p1; s4). The results are concise and contain the future directions for research, including potential measures and outcomes of PCC (P11; RC; p1; s5).
A Systematic Review
The review question is clearly explained in the first three pages of the paper. It concludes with the research question – whether psychological interventions are effective for smoking secession in adults with mental health problems with or without pharmacotherapy (P618; p3; s1). To answer such a broad question, the researchers state five detailed questions about the interventions with or without NRT and overall effectiveness to be answered in the review (P618; p4; s1-5). The inclusion criteria were appropriate as they narrowed the research to exploring the specific population (over 16 years old (P619; p2; s1)), type of study (RCTs P619; p3; s1)), interventions (psychological and relapse prevention (P619; p4; s1)) and outcome measures (changes in smoking behavior and the number of cigarettes smoked a day (P620; p2; s1)). The search strategy and the sources were appropriate as the most modern electronic databases, scanning contents, and reference lists (P618; p6; s1) in the fields of psychology (P618; p6; s2) were analyzed.
The studies were carefully analyzed based on the heterogeneity of the participants’ diagnoses, types of interventions, settings, follow-up, and outcome measures (P621; p3; s2). The wide range of criteria shows the appropriateness of the selected works. Moreover, the appraisal was conducted by blind inspection of two researchers to retain the credibility of the study (P621; p3; s1). The possible risk of bias or mistakes was assessed though the Cochrane risk of bias tool to ensure the validity of the review (P621; p2; s1) (Lightfoot et al., 2020). The studies’ combination was appropriate as the data were synthesized by considering the change in smoking behavior between the target date and the end of the intervention and the target end date of intervention and the follow-up (P621; p4; s1). The following division allowed the authors to portray the selected RCTs’ effectiveness in a specific period.
The study also highlighted the limitations of the research based on the compared RCTs. The heterogeneity of diagnoses and needs of people with mental issues require an in-depth analysis (P633; p4; s5). The three listed limitations of possible bias (P633; p2; s1), little evidence to compare the effectiveness (P633; p3; s1), and the heterogeneity of the studies (P633; p5; s1) were the points that the authors encouraged the future researchers to work on (P633; p6; s1).
References
Lightfoot, K., Panagiotaki, G., & Nobes, G. (2020). Effectiveness of psychological interventions for smoking cessation in adults with mental health problems: A systematic review.British journal of health psychology, 25(3), 615–638. Web.
Marchand, K., Beaumont, S., Westfall, J., MacDonald, S., Harrison, S., Marsh, D. C.,… & Oviedo-Joekes, E. (2019). Conceptualizing patient-centered care for substance use disorder treatment: findings from a systematic scoping review.Substance abuse treatment, prevention, and policy, 14(1), 37. Web.
Rüther, T., Ruderer, A., Wirth, C., Schuler, V., Lang, V., Linhardt, A.,… & Pogarell, O. (2016). Smoking Cessation Program for Inpatients with Substance Use Disorder: A Quasi-Randomized Controlled Trial of Feasibility and Efficacy. European addiction research, 22(5), 268-276. Web.
Wilson, S. M., Thompson, A. C., Currence, E. D., Thomas, S. P., Dedert, E. A., Kirby, A. C.,… & Beckham, J. C. (2019). Patient-informed treatment development of behavioral smoking cessation for people with schizophrenia.Behavior therapy, 50(2), 395-409. Web.
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