Respond to at least two colleagues on two different days in one or more of the f

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Respond to at least two colleagues on two different days in one or more of the f

Respond to at least two colleagues on two different days in one or more of the following ways:
Ask a probing question, substantiated with additional background information, evidence, or research.
Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
Validate an idea with your own experience and additional research.
Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence
Colleague post 1
Initial posting
The effect of mindfulness-based mandala activity on anxiety and spiritual well-being levels of senior nursing students: A randomized controlled study.
https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=rzh&AN=160402148&site=ehost-live&scope=site&custid=s6527200
Purpose: The purpose of the study was to determine the effectiveness of utilizing mindful-based mandala practices on anxiety and spirituality of fourth year undergraduate nursing students whose clinical rotation was interrupted by the COVID-19 pandemic. Fourth-year students in the eighth and final semester of clinical practice post COVID distancing were the only participants in the study. The student’s clinical internship was interrupted, and distance learning started in the spring of 2019 and went through the fall term in 2021.
Study population: The students in the study had begun their fourth-year nursing clinical rotation. Four-weeks after initiating the in-person clinical rotation it was necessary to begin distance learning due to restrictions during the COVID-19 pandemic. Initially two hundred fourth-year undergraduate students met the initial criteria of being in the registered theory & clinical practice course, having internet access and agreement to participate in the study. After the exclusion criteria of having received psychiatric treatment, having a substance addiction and/or prior participation in mindfulness therapy, there were 180 total eligible participants. There were initially ninety experimental group participants and ninety control group participants. Exposure to COVID-19 caused two students to drop out and interruption of internet access caused four additional participants to drop out of the experimental group leaving eighty-four student participants. Four of the control group student participants dropped out of the study leaving eighty-six student participants in the control group. No further loss of experimental or control group participants occurred; experimental group n = 84 and control group n = 86, total group 170.
Length of the trial: The study sessions lasted three consecutive weeks during the pandemic distancing/quarantine. The control group participated in mindfulness mandala drawing once weekly for three consecutive weeks over a Zoom meeting during COVID distancing. Sessions were provided at one-hour intervals, three times a day five days a week for flexibility of attendance. Initial pre-testing occurred the week before the final clinical rotation began and the last tests occurred at the end of the clinical rotation.
Data collection methods: Randomization of the experimental and control group was completed by an outside researcher utilizing research randomizer software. Identification of group participants remained concealed until interventions began. Research data was entered into the SPSS program and identified as A & B. A statistician and non-research instructor completed the statistics and coded analysis. The G-power showed a strength of 99% with the study being reported in agreement with CONSORT. Pre/post testing, data collection and assessment instruments collected through google forms.
Descriiptive characteristics and the instruments used initially and at three weeks to determine in anxiety, wellness and spirituality are: Spielberg State Trait Anxiety Inventory (STAI), Spiritual Well-Being Scale (SWBS) and the Scale of Positive and Negative Experiences (SPANEs). The STAI scale is a five-minute, twenty question assessment using a Likert-scale to determine anxiety levels that are administered at the beginning of the study and after the final mandala session. The Spiritual Well-Being Scale is a five-minute, twenty-nine question assessment using a Likert-scale to determine spiritual well-being that is administered at the beginning of the study and after the final mandala session. SPANE is a 12-question google survey determining higher positive and negative emotions before and after each of the three mandala sessions. The first mandala session presented the mandala philosophy, breathing exercises, guided imagery, and drawing of an intention mandala. The second mandala session included breathing exercises, guided imagery, and drawing a stress mandala. The third session included breathing exercises, guided imagery and drawing the I mandala. All mandala’s created over the three weeks were encouraged to be hung in rooms.
Outcome measures: mindfulness art and coping strategies were found to be effective in reduction of anxiety, improving spiritual well-being, and self-awareness. Anxiety scores were found to be statistically significant among the fourth-year experimental group. The study indicated in literature research the individual aspects of the study showed evidence of effectiveness but there were no other studies that included the mindfulness techniques and mandala drawing in the treatment of psychological well-being and coping skills development.
Results and conclusions: The study recommended mandala drawing sessions, breathing exercises and guided imagery to assist in the psychological and emotional wellbeing of high stress occupations particularly during pandemic situations. At the end of the study the mindfulness mandala sessions were made available to the other students for improved psychological wellness and recommended for inclusion in nursing programs.
The ethical issue associated with the study is the lack of indication that informed consent was obtained. This was a single-blind, parallel-group randomized controlled, pretest-posttest study. The participants were students in their final semester of nursing school, it did not indicate participation was voluntary, but students were able to withdraw from the study.
The experimental design used was a single-blind, parallel-group randomized controlled study. The purpose of a randomized controlled study hypothesizes the relationship between the introduction of an intervention or therapeutic measure to formulate strategies to prevent disease (Friis & Sellers, 2021). Randomized controlled trials are effective in the determining if an intervention is effective to a controlled group (Curley, 2020). This study was able to determine the use of mindfulness and mandala art therapy was effective in the psychological wellness of nursing students during their final clinical rotation after experiencing interruption in their prior rotation due to COVID-19. Using a randomized controlled trial, it enabled the direct comparison of subjects with similar experiences impacting their psychological distress. The relief of psychological distress to the experimental group indicated the potential significance of complimentary therapy to relieve psychological distress among high stress schooling/occupations.

Colleague post 2
Week 4 Post
Randomized Controlled Trial of a Community Health Worker Self-Management Support Intervention Among Low-Income Adults With Diabetes, Seattle, Washington, 2010-2014.
A randomized controlled (RCT) study assigns participants into a control and experimental group. An RCT is a form of intervention study where intervention is designed to test a hypothesis (Friis & Sellers, 2021). A randomized controlled study reduces bias, assesses a controlled experiment, and demonstrates statistical efficiency. The primary outcome being examined in an RCT is the variable being studied. In the following identified study, the variable is the HgA1c values. Type 2 diabetes is in an epidemic state. Community health groups worldwide are working to educate and assist people with diabetes in better self-management not to develop or worsen comorbidities. An RCT was completed to assess the effects of diabetic education and HgA1c levels.
Purpose.
To determine if community health workers (CHWs) can improve diabetes outcomes among low-income adults.
Study population.
The study population included type 2 diabetic residents of King County, Washington, between 30 and 70, whose HgA1c was 8% or more outstanding with a household income of less than 250% of the federal poverty level. The participants’ exclusion criteria included not being homeless or having plans to move out of the area, not having a severe illness such as cancer or end-stage renal disease requiring hemodialysis, not having dementia, not participating in another diabetes study, or not being unable to give informed consent (Nelson et al., 2017). After obtaining informed consent and baseline data, the researchers randomly assigned participants to the intervention or usual care (control) group.
Length of Trial
The study took place over a 12-month time frame. Participants were initially assessed for eligibility based on their clinic-reported HgA1c level. Once assessed as eligible, the participants were screened when study eligibility was determined, and the participants were randomized into control and intervention groups. The control group was then seen as usual at a 12-month exit. Diabetic education was offered to the control group at that time. The intervention group was seen for four mandatory visits on days 15, 45, 95, and seven months with an optional visit ten months after enrollment in the study. There was a 12-month exit for the intervention group as well.
Data Collection Methods.
Baseline data (90%) and exit data (91%) were collected for participants with an HgA1c, lipid panel, blood pressure, and weight. Participants’ clinic values were used when not able to be collected. The intervention group data collection consisted of a diabetes self-management assessment determined by a structured interview given by the CHW. The CHW would then set health goals with the participants and document these goals. All data were reviewed, and monthly audits were completed to ensure the intervention-required components were completed (Nelson, 2017).
Outcome Measures

The outcome measure studied was HgA1c levels. A secondary outcome included the health-related quality of life assessed through a self-reported number of outpatient clinic visits, hospitalizations, and emergency department encounters during the study year. Additionally, medication compliance and level of physical activity were measured using interviews and physical activity questionnaires.
Results and Conclusions.
The HgA1 levels did not significantly improve the intervention group over the control group. The intervention group did report fewer clinic visits than the usual care group. The researchers’ study was intended to be a low-intensity study, which they felt may not have been strong enough to demonstrate a significant change in HgA1c or disease self-management (Nelson et al., 2017).
Ethical Issues Associated with the Study.
The participants in this study gave informed consent for participation in the study. Informed consent provides the participants with the risks and benefits of participating in the study. Disclosure regarding the purpose of the study is explained. Having information about the survey allows the participant to decide whether to participate in the study or withdraw (Friis &Sellers, 2021). This study did not involve any medication. It involved education and goal setting. Education is readily available through the community clinic or social media. All precautions were taken with this study to ensure no unethical experimentation was in place.

Original question
Search databases in the Walden Library and locate a peer-reviewed article from the last 5 years that uses a randomized controlled trial study design. The subject of the study may be any topic professionally relevant or interesting to your practice. You may not select an article already posted by one of your colleagues for this Discussion. (Tip: When searching, you may use “randomized trial” as one of your search phrases.)
Critically analyze the following aspects of the research study:
Purpose
Study population
Length of the trial
Data collection methods
Outcome measures
Results and conclusions
Ethical issues associated with the study
Ask yourself: How did this research study benefit from its experimental design? What was achieved by randomization that might not otherwise have been achieved?
BY DAY 3 OF WEEK 4
Post a cohesive scholarly response that addresses the following:
Summarize the research study addressing the aspects bulleted above.
Identify and discuss the ethical issues associated with this study.
Be sure to include a link to the article in your post.
NB
EACH RESPONSE MUST HAVE A SEPARATE REFERENCE PAGE
EACH RESPONSE MUST HAVE AT LEASST TWO REFERENCES IN APA
REFERENCES MUST BE LESS THAN GIVE YEARS
NO DATE REFERENCES NOT ACCEPTABLE
REMEMBER IT IS A RESPONSE TO A POST

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