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Evidence-Based Practice in Nursing

Evidence-BasedPractice in Nursing

Evidence-BasedPractice in Nursing

Theconcept of evidence-based practice has become instrumental inensuring quality nursing, which is based on facts derived fromstudies conducted on the population of individuals to receive healthcare. This research paper details the method of evidence-basedpractice by performing a critique of a selected article related tothe practice, which is the work on stroke education for AfricanAmerican females by Beal 2015. Among the areas critically discussedinclude the research question, research design, sample selection,methods of data collection, limitations of the study, study findings,and the article summary.



Thestudy by Beal (2015) aimed to examine the need for educationregarding stroke by the African American women. In order to fulfillthat purpose, there was a need to formulate research questions whichare relevant to the topic, and can be answered at the end of thestudy. Hence, Beal (2015) formulated two research questions to act asthe guideline for the study. The first question aimed to find out theviews the African American women held regarding the stroke causes,seriousness, and health consequences. Additionally, Beal (2015)introduced a second research question to determine how AfricanAmerican women gained health information outside the environment ofmedical encounters.


Realizingthat the group that was to be assessed comprised of subjects who hadencountered the problem in question (stroke), and that they wereculturally sensitive (i.e. African American women), Beal (2015)carefully selected an exploratory-descriptive research design.Through qualitative methods, it was possible to acquire the women’sperceptions while also attending to their cultural and social issues.In order to instill confidence in the study subjects, Beal (2015)obtained an approval from the review board of the University, andthen settled for Black churches, which were opted for because theyaccommodate most African American women, the target group for thestudy. For total approval, the pastors were also contacted, and withtheir consent, it was time to work out the sample for the study.


Becausethe study aimed to determine the education needs of African Americanwomen concerning stroke, it was necessary to work with a samplerepresentative of those who experience the problem. Hence, the lowestage for participants selected by Beal (2015) was 35 because strokeincidences reported in African American women of age range 35 to 44are very high. Consequently, Beal (2015) decided to work with an agemargin of 38 to 88 years, with the mean age established as 68.6years. The total number of participants considered for the researchwas 48 African American women, and this was obtained from fourchurches. As an explorative-descriptive study meant to use the viewsof a small group as the baseline to make inferences to the entirepopulation regarding stroke and the need for African Americaneducation, the sample utilized by Beal (2015) was reliable. Even thesample characteristics showed how dependable concerning the studyand the features included the following: 53.6 percent of the AfricanAmerican women studied owned a degree from college or university, 83percent of the subjects reported hypertension, 14.9 percent reporteddiabetes, and 12.8 percent reported 12.8 percent heart disease, thethree leading risk areas for stroke.

DataCollection Methods

Thedesign of the study by Beal (2015) was identified asexplorative-descriptive, mainly gathering the views of the subject.Hence, the data collection approach utilized was a survey, in whichfocus groups comprising of 6 to 10 respondents (African Americanwomen) engaged in a 90-minute discussion forum for every group. Topotentiate the outcomes of the focus groups, interview sessions whichmade use of open-ended questions were conducted, and a digitalaudio-recorder utilized to record the oral responses for futureanalysis. The necessity for dependable responses prompted theresearcher to motivate each subject through a gift card worth USD 25.The survey provided information that needed to be organized forutilization by the public, and that brought about the need foranalysis. Beal (2015) made use of thematic analysis whereby the audiorecordings were awarded verbatim. In that analysis, data coding wasdone to come up with themes and subthemes in a table that condensedall the related codes under the same theme or subthemes, with morecodes added until the final focused group was covered. Interestingly,Beal (2015) considered the views of 16 out of the 48 subjects in dataanalysis, a guarantee that the results harbored no (or insignificant,if any) bias, and that the findings of the study were transferable.

Becausethe study involved a culturally sensitive group, the issues ofcredibility, dependability, and transferability were serious areas ofconsideration in data handling. Beal (2015) adequately considered thethree areas in the way the research was approached. First, to ensurecredibility, focus groups were used to model associations that takencare of the cultural disparity, and groups were continued tosaturation to ensure that the respondents expressed themselves fullby the end of the survey. Moreover, for a more successful datainterpretation, Beal (2015) conducted member validation summitsalongside several representative quotes. Second, to guaranteedependability, the inconsistencies associated with surveys (due tonew questions, ideas, and responses emerging), subsequent groups wereutilized to attend to the emerging issues. Finally, gaugingtransferability, that is, the judgment of a reader regarding theapplicability of the findings, was made possible by the inclusion ofthe experiences of the respondents as shown in their own expressionsand demographic data.


Thestudy by Beal (2015) had some limitations with respect to the way theresults were generalized using the small sample of 48 subjects.Specifically, there was religious and geographic homogeneity of therespondents, who were obtained from Black churches in two urbanareas there was no representation for the rural regions and,therefore, women from such areas, and non-black church members, maynot be covered for in the results. Besides, the research did notconsider the income background of the participants, and that limitedthe interpretation of the subjects’ perceptions in relation to thehousehold incomes. Finally, the women who participated may have hadindividual preference of heart disease, hence giving biased viewswhich may not favorably represent the church-going group of AfricanAmerican women.


Athematic analysis of the survey outcomes identified four theme areasas the key findings of the study by Beal (2015). The first area,coded as “we are none in the know about stroke,” was indicativeof the fact that the African American women lacked sufficientknowledge about stroke. That was so because nobody talked to themabout the disease, with the most common issue in the public domainbeing cancer. In other words, there has been laxity and less effortin creating awareness among the African American women regardingstroke, hence the uncertainties about the physiology of the disease.

Thesecond theme area, coded as “if you are Black, you are at risk forstroke,” confirmed that the African Americans were well aware thatstroke incidences are high amongst the Blacks than the Whites. Theyattributed that discrepancy to the family responsibility frustration,economic inequality, and racial prejudice. There stresses they faceare the result of high blood pressures reported, and that in turn hasoften ended with stroke among the Black race (Beal, 2015).

Thethird theme, transcribed as “most of our concern would be cancer,”pinpointed the fact that African Americans believed that cancer ofthe breast is a leading threat to life among the Blacks. They viewstroke as a disease that happens suddenly, unlike cancer, which theyposited is hidden and only appears at a time that nothing can be doneto save the victim (Beal, 2015). In other words, the African Americanwomen believed that those who suffered a first stroke or heart attackand survived can be helped, and that is unlikely for breast cancercasualties.

Thefourth finding, coded as “you can’t get too much information,”proved that regardless of the interest the women had to acquireknowledge related to stroke, the information available was inadequateto meet their quests. The sources they pinpoint as helpful in thegaining of health information include: Google, television shows, andface-to-face conversation with a family member or a friend,preferably Black female colleagues in both cases, who encountered aparticular health challenge and visited a health practitioner forhelp (Beal, 2015).


Thearticle by Beal (2015) was a major pillar in uncovering the issue ofstroke among the African Americans. With the study questions,research design, data collection and analysis and representationcorrectly structured, amazing results were obtained as far as strokeamong the women was concerned. Evidently, the results of the studyshowed that African American women display less awareness of stroke,with a majority reporting only beliefs (they were not sure) aboutwhat brings about stroke. The scenario presented is such that theAfrican Women associate chest pains (usually indicative of heartdisease) to be stroke symptom, with most of them concurring that theyface stroke problems as a result of the increase heart disease andhigh blood pressure among them. Simply put, the women lackinformation about the physiology of stroke, and that calls for theneed to introduce education programs aimed to enlighten the groupabout the disease. Moreover, the study determined that few physiciansengage the women in talks related to stroke, with most of the womenalways told about breast cancer whenever they see a doctor ascompared to discussions related to stroke. That has significantlycontributed to the less awareness among women with respect to thecauses, seriousness, and consequences of stroke.

Encouragingly,the findings of the study determined potential platforms that can bedecisive in the creation of awareness about stroke. First, because amajority of African American women mentioned television shows as oneof the avenues through which they gain knowledge about health issues,Beal (2015) argued that health programs related to stroke should beincluded in the shows to help expose the African American womenconcerning the physiology of stroke. Besides, the physicians, whencontacted by the African American females aged 35 years onwards,should openly talk about stroke alongside other diseases to raiseawareness. Also, the article revealed that most of the AfricanAmerican women surf the website to gain information on health.Therefore, it is imperative to have specific internet sites withlatest and accurate information about stroke to help expose the womento the physiology of the disease. Finally, the issue of incomeinequality and racial prejudice has contributed to the highprevalence of stroke among the African American females, and thatcalls for an intervention to help address the variations (Beal,2015).


Fromthe considerations above, it is patent to conclude that the AfricanAmerican women are not adequately informed about the causes,seriousness, and health consequences of stroke. Therefore, educationinterventions should be brought forth to help avert that situation.Among the two leading response areas are the inclusion of strokeprograms in TV shows, and the creation of a permanently functioningwebsite with constant updates on stroke.


Beal,C. C. (2015). Stroke Education Needs of African AmericanWomen.&nbspPublicHealth Nursing,&nbsp32(1),24-33.