NRS 433V Ethical Considerations Essay

Literature Evaluation Table Student Name: Karelia Falcon Summary of Clinical Issue (200-250 words): The nursing practice problem for the research is the use of oral contraceptives in women between the ages of 25-40 which can develop blood clots. Oral contraceptives are used to prevent pregnancy. Individuals who use oral contraceptive method containing estrogen have higher risks of blood clots in comparison with those who do not use oral contraceptives. Majority of oral contraceptives contain Drosperinone therefore women who use them are likely to develop vein thrombosis which is a form of blood clots. According to various statistics, a lower percentage of women aged 25-40 are less at risk of developing deep vein thrombosis especially in the legs. However, the women using the pill are also about 1.3 to 2.5 times more likely to experience stroke and heart attack cases than those who do not. Blood clots are not very common among individuals who are not pregnant and under the age of 45 years. Estrogen or progesterone oral contraception pills affects blood clotting by increasing plasma fibrinogen and the activity of coagulation factors. The changes are as a result of the taking the pill may cause blood clots in the women taking the pills. The risk of blood clot may also depend on the type of progestin. The reason is that pills that contain higher levels of progestin levonorgestrel tend to have lower risks of developing venous thromboembolism. When deep vein thrombosis develops, it can cause serious injuries to the lungs if a piece of a clot breaks free and becomes free to flow in the blood stream. NRS 433V Ethical Considerations Essay

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PICOT Question: Are women at an age range of 25 – 40 that take oral contraceptives at a higher risk to develop blood clots versus women at the same age range who use IUDs for contraception over a 5-year span? © 2019. Grand Canyon University. All Rights Reserved. The population for the PICOT question are the women aged between 25-40 years who use various contraceptives. The patient problem is the how the use of oral contraceptives cause the risks of blood clots for women aged between the target age group. The patient problem also describes the effects of IUDSs for contraception over 5 year span for women in the target age group. The women aged between 25-40 years who take IUDs for longer periods are most likely to develop blood clots because they do not contain estrogen. The intervention method for the targeted age group would involve counselling intervention method based on theory and behavioral methods. The intervention methods aims at assisting the women in the target group to select the appropriate birth control pills that would promote their healthy development. Criteria APA-Formatted Article Citation with Permalink How Does the Article Relate to the PICOT Question? Article 1 Article 2 Kaller, S., Mays, A., Freedman, Tepper, N. K., Whiteman, M. K., L., Harper, C. C., & Biggs, M. A. Marchbanks, P. A., James, A. H., (2020). Exploring young & Curtis, K. M. (2016). women’s reasons for adopting Progestin-only contraception and intrauterine or oral emergency thromboembolism: a systematic contraception in the United review. Contraception, 94(6), States: a qualitative study. BMC 678-700. women’s health, 20(1), 15. The article relates to the PICOT The article relates to the PICOT question because it explains the question because it explores the effects of progestin only young women reason’s for using contraception oral contraceptive pills are compared to IUDs Article 3 Manzoli, L., De Vito, C., Marzuillo, C., Boccia, A., & Villari, P. (2012). Oral contraceptives and venous thromboembolism. Drug safety, 35(3), 191-205. The article relates to the PICOT question because it explores uncertainties related form using oral contraceptives. Quantitative, Qualitative (How do you know?) NRS 433V Ethical Considerations Essay

The article provides a quantitative on a number of women in general population. Purpose Statement To identify evidence regarding the risk of venous thromboembolism (VTE) or arterial thromboembolism [stroke or acute myocardial infarction (AMI)] among women using POCs. Research Question Progestin-only contraception and thromboembolism: A systematic review Outcome Setting (Where did the study take place?) The outcome of the study is to identify the risk of venous thromboembolism for women taking progestin contraceptions and IUDs The study took place from the research of the PubMed database The article is a qualitative study from a sample of young women in the US The article is a quantitative analysis from studies in the early 1960s on Oral contraceptives and venous thromboembolism. To identify factors that influence patients’ choice between ECPs and the copper IUD as EC, including prior experiences with contraception and attitudes toward EC methods, in settings where both options are available at no cost. What is the choice between IUDs and Emergency Contraceptives Pills? The majority of post-thrombotic women are barred from using oral contraceptives. The article evaluated this policy for its clinical relevance. Women chose ECPs because they were familiar and easily accessible. Reasons for not adopting the copper IUD included having had prior negative experiences with the IUD, concerns about its side effects and the placement procedure, and lack of awareness about the copper IUD. The study focuses on the use of contraceptive methods in clinical settings Summary thrombosis risk for oral contraceptive users, number needed to discontinue oral contraceptives to prevent one (recurrent) thrombosis, comparison of additional unwanted pregnancies and postpartum thrombosis between alternative birth-control methods. What are the uncertainties related from using oral contraceptives A Medline computer search, from 1966 to 1993, in multiple languages, with the following Sample The sample involves 29 studies of women from the general population Method The research method involves research from the PubMed database Key Findings of the Study Two studies found that use of POCs for therapeutic indications was associated with increased odds of VTE Participants, both those who adopted ECPs or the IUD, reported visiting the clinic because they had had unprotected sex or experienced a method failure and did not want to be pregnant. All women who had an IUD placed and most who received ECPs had heard about the IUD before their visit. Few knew that the IUD could be used as EC until their current clinic visit Interviews from17 patients seeking EC from three San Francisco Bay Area youthserving clinics that offered the IUD as EC and ECPs as standard practice, regarding their experiences choosing an EC method Most women were familiar with or had had positive experiences with ECPs before their visit, and would recommend them to others. Women described their appreciation for a post-coital contraceptive option that was index terms: thrombosis, thrombopheblitis, vein, venous, pulmonary embolism, contraceptives, oestrogen, oral. Total of 588 articles or abstracts were reviewed for controlled studies, in which an index group was compared with a control group. Included were one randomized trial, six follow-up studies and eight case-control studies.NRS 433V Ethical Considerations Essay

The study uses a meta-analysis method of a total of 588 articles were reviewed for controlled studies The studies proved highly heterogeneous with regard to size and direction of the risk estimate. The summary relative risk of first thrombosis during oral contraceptive use was 2.9 (95% CI, 0.5-17). Recommendations of the Researcher Criteria effective and easy to obtain at their clinic. Limited evidence suggested The study highlights that women increased odds of VTE with use have varied and well-considered of injectable (three studies) and reasons for choosing each EC use of POCs for therapeutic method. Both ECPs and the indications (two studies, one with copper IUD are important and POCs unspecified and the other acceptable EC options, each with with POPs). their own features offering benefits to patients. Article 4 Article 5 APA-Formatted Article Citation with Permalink de Bastos, M., Stegeman, B. H., Rosendaal, F. R., Vlieg, A. V. H., Helmerhorst, F. M., Stijnen, T., & Dekkers, O. M. (2014). Combined oral contraceptives: venous thrombosis. Cochrane Database of Systematic Reviews, (3). How Does the Article Relate to the PICOT Question? The article relates to the PICOT question because it describes causes of venous thrombosis from using combined contraceptives Dolan, H., Li, M., Bateson, D., Thompson, R., Tam, C. W. M., Bonner, C., & Trevena, L. (2021). ‘Every medicine is part poison’: a qualitative inquiry into the perceptions and experiences of choosing contraceptive methods of migrant Chinese women living in Australia. BMC women’s health, 21(1), 1-13. The article relates to the PICOT question because perceptions of choosing contraceptive methods among women he outcome with regard to pregnancies and thrombosis in 5 hypothetical cohorts of 100,000 post-thrombotic women monitored for 1 year indicated that under all but the highest assumption for recurrence risk, among typical couples the number of unexpected pregnancies as well as thrombotic episodes would be highest among condom users Article 6 Madden, T., Cortez, S., Kuzemchak, M., Kaphingst, K. A., & Politi, M. C. (2016). Accuracy of information about the intrauterine device on the Internet. American journal of obstetrics and gynecology, 214(4), 499-e1. The article related to the PICOT question because it describes the accuracy of information regarding the use if IUDs Quantitative, Qualitative (How do you know?) Purpose Statement The article is a quantitative analysis article which applies a meta-analysis in its research To provide a comprehensive overview of the risk of venous thrombosis in women using different combined oral contraceptives. NRS 433V Ethical Considerations Essay

Research Question What are the effects of using different oral contraceptive pills for younger women The primary outcome of interest was a fatal or non-fatal first event of venous thrombosis with the main focus on deep venous thrombosis or pulmonary embolism. Outcome Setting (Where did the study take place?) Sample Method The study was from electronic database settings The selected studies included healthy women taking Combined oral contraceptives with VT as outcome. The article is a qualitative study using a thematic analysis method The article is a qualitative study using sources from the internet Understanding the influencing factors of Chinese migrant women’s contraceptive method choice and practices will help cater to their decision-making needs in a culturally sensitive and responsive way. What are the experiences of choosing contraceptives among Chinese women? Four major themes were identified, including: ‘every medicine is part poison: hormonal contraceptives cause harm to the body’; ‘intrauterine device, a device used in the past for married women The study was from Ottawa Decision Support Framework To evaluate the quality of information about intrauterine devices (IUDs) among websites providing contraceptive information to the public. Semi-structured interviews were conducted with 22 women who self-identified as being ethnically Chinese and had been living in Australia for no more than 10 years Electronic databases were Interviews were conducted in searched in 22 April 2013 for Mandarin Chinese. Transcribed eligible studies, without language data was analyzed using thematic restrictions. analysis method. What are the effects of using intrauterine devices (IUDs) to women? Clinicians need knowledge about accurate, evidence-based Internet resources to provide to women given the inconsistent quality of information available through online sources. The study was from internet database settings The search identified over 2000 websites, of which 108 were eligible for review; 105 (97.2%) of these sites contained information about IUDs The research developed a 56item structured questionnaire to evaluate the quality of Key Findings of the Study Recommendations of the Researcher Incidence of venous thrombosis in non-users from two included cohorts was 0.19 and 0.37 per 1 000 person years, in line with previously reported incidences of 0,16 per 1 000 person years. Use of combined oral contraceptives increased the risk of venous thrombosis compared with nonuse (relative risk 3.5, 95% confidence interval 2.9 to 4.3) All combined oral contraceptives investigated in this analysis were associated with an increased risk of venous thrombosis. NRS 433V Ethical Considerations Essay

The effect size depended both on the progestogen used and the dose of ethinylestradiol. Chinese migrant women’s perceptions and experiences of choosing contraceptive methods are influenced by complex personal, cultural, societal and inter-relational factors. Chinese migrant women were cautious of using hormonal methods due to fears of sideeffects, including reduced or absent menstrual bleeding. Women were also reluctant to consider intrauterine devices as options due to associating them with past experiences of other women and themselves and also fears of potential complications information about IUDs available through the Internet. The quality of information about IUDs available on the Internet is variable. Accurate information was mixed with inaccurate or outdated information that could perpetuate myths about IUDs Clinicians can benefit from identification of websites with accurate and transparent information. Knowledge about reliable websites could serve as resources for clinicians and patients to improve contraceptive counseling and support informed, evidence-based contraceptive decision making. References de Bastos, M., Stegeman, B. H., Rosendaal, F. R., Vlieg, A. V. H., Helmerhorst, F. M., Stijnen, T., & Dekkers, O. M. (2014). Combined oral contraceptives: venous thrombosis. Cochrane Database of Systematic Reviews, (3). Dolan, H., Li, M., Bateson, D., Thompson, R., Tam, C. W. M., Bonner, C., & Trevena, L. (2021). ‘Every medicine is part poison’: a qualitative inquiry into the perceptions and experiences of choosing contraceptive methods of migrant Chinese women living in Australia. BMC women’s health, 21(1), 1-13 Kaller, S., Mays, A., Freedman, L., Harper, C. C., & Biggs, M. A. (2020). Exploring young women’s reasons for adopting intrauterine or oral emergency contraception in the United States: a qualitative study. BMC women’s health, 20(1), 15. Madden, T., Cortez, S., Kuzemchak, M., Kaphingst, K. A., & Politi, M. C. (2016). Accuracy of information about the intrauterine device on the Internet. American journal of obstetrics and gynecology, 214(4), 499-e1. Manzoli, L., De Vito, C., Marzuillo, C., Boccia, A., & Villari, P. (2012). Oral contraceptives and venous thromboembolism. Drug safety, 35(3), 191-205. Tepper, N. K., Whiteman, M. K., Marchbanks, P. A., James, A. H., & Curtis, K. M. (2016). Progestin-only contraception and thromboembolism: a systematic review. Contraception, 94(6), 678-700. Research Critique Guidelines – Part I Use this document to organize your essay. Successful completion of this assignment requires that you provide a rationale, include examples, and reference content from the studies in your responses. Qualitative Studies Background of Study 1. Summary of studies. Include problem, significance to nursing, purpose, objective, and research question. How do these two articles support the nurse practice issue you chose? 1. Discuss how these two articles will be used to answer your PICOT question. 2. NRS 433V Ethical Considerations Essay

Describe how the interventions and comparison groups in the articles compare to those identified in your PICOT question. Method of Study: 1. State the methods of the two articles you are comparing and describe how they are different. 2. Consider the methods you identified in your chosen articles and state one benefit and one limitation of each method. Results of Study 1. Summarize the key findings of each study in one or two comprehensive paragraphs. 2. What are the implications of the two studies in nursing practice? Ethical Considerations 1. Discuss two ethical consideration in conducting research. 2. Describe how the researchers in the two articles you choose took these ethical considerations into account while performing their research. © 2019. Grand Canyon University. All Rights Reserved. Course Code NRS-433V Class Code NRS-433V-O502 Criteria Content Percentage 75.0% Qualitative Studies 5.0% Background of Study 10.0% Article Support of Nursing Practice Issue 15.0% Method of Study 15.0% Results of Study 15.0% Ethical Considerations 15.0% Organization and Effectiveness 15.0% Thesis Development and Purpose 5.0% Argument Logic and Construction 5.0% Mechanics of Writing (includes spelling, punctuation, grammar, language use) 5.0% Format 10.0% Paper Format (use of appropriate style for the major and assignment) 5.0% Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 5.0% Total Weightage 100% Assignment Title Rough Draft Qualitative Research Critique and Ethical Considerations 1: Unsatisfactory (0.00%) Only one article is presented. Neither of the articles presented use qualitative research. Background of study, including problem, significance to nursing, purpose, objective, and research questions, is incomplete. Discussion on how articles support the PICOT question is incomplete. Discussion on the method of study for each article is omitted. The comparison of study methods is omitted or incomplete. Discussion of study results, including findings and implications for nursing practice, is incomplete. Discussion of ethical considerations when conducting nursing research is incomplete. A discussion on ethical considerations of the two articles presented in the essay is incomplete. Paper lacks any discernible overall purpose or organizing claim. Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used. Template is not used appropriately or documentation format is rarely followed correctly. Sources are not documented. Total Points 190.0 2: Less Than Satisfactory (75.00%) Two articles are presented. Of the articles presented, only one article is based on qualitative research. NRS 433V Ethical Considerations Essay

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Background of study, including problem, significance to nursing, purpose, objective, and research questions, is included but lacks relevant details and explanation. A summary of how articles support the PICOT question is presented. It is unclear how the articles can be used to answer the proposed PICOT question. Significant information and detail are required. A partial summary of the method of study for each article is presented. The comparison of study methods is incomplete. A benefit and a limitation of each method are omitted or incomplete. There are significant inaccuracies. A summary of the study results includes findings and implications for nursing practice but lacks relevant details and explanation. There are some omissions or inaccuracies. Discussion of ethical considerations when conducting nursing research is included but lacks relevant details and explanation. A discussion on ethical considerations of the two articles used in the essay is summarized but there are significant inaccuracies or omissions. Thesis is insufficiently developed or vague. Purpose is not clear. Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present. Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. 3: Satisfactory (83.00%) N/A Background of study, including problem, significance to nursing, purpose, objective, and research questions, is partially complete and includes some relevant details and explanation. A general discussion on how articles support the PICOT question is presented. The articles demonstrate general support in answering the proposed PICOT question. It is unclear how the interventions and comparison groups in the articles compare to those identified in the PICOT question. Some rational or information is needed. A general discussion on the method of study for each article is presented. The comparison of study methods is summarized. A benefit and a limitation of each method are summarized. There some inaccuracies or partial omissions. More information is needed. Discussion of study results, including findings and implications for nursing practice, is generally presented. Overall, the discussion includes some relevant details and explanation. Discussion of ethical considerations when conducting nursing research is partially complete and includes some relevant details and explanation. A discussion on ethical considerations of the two articles used in the essay is discussed but there are some inaccuracies, or some information is needed. Thesis is apparent and appropriate to purpose. Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. NRS 433V Ethical Considerations Essay

Sources used are credible. Introduction and conclusion bracket the thesis. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. Template is used, and formatting is correct, although some minor errors may be present. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. 4: Good (94.00%) N/A Background of study, including problem, significance to nursing, purpose, objective, and research questions, is complete and includes relevant details and explanation. A discussion on how articles support the PICOT question is presented. The articles demonstrate support in answering the proposed PICOT question. The interventions and comparison groups in the articles compare to those identified in the PICOT question. Minor detail or rational is needed for clarity or support. A discussion on the method of study for each article is presented. The comparison of study methods is generally described. A benefit and a limitation of each method are presented. There minor are inaccuracies. Some detail is required for accuracy or clarity. Discussion of study results, including findings and implications for nursing practice, is complete and includes relevant details and explanation. Discussion of ethical considerations when conducting nursing research is complete and includes relevant details and explanation. A discussion on ethical considerations of the two articles used in the essay is presented; some detail in needed for accuracy or clarity. NRS 433V Ethical Considerations Essay

Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used. Template is fully used; There are virtually no errors in formatting style. Sources are documented, as appropriate to assignment and style, and format is mostly correct. 5: Excellent (100.00%) Two articles are presented. Both articles are based on qualitative research. Background of study, including problem, significance to nursing, purpose, objective, and research questions, is thorough with substantial relevant details and extensive explanation. A clear discussion on how articles support the PICOT question is presented. The articles demonstrate strong support in answering the proposed PICOT question. The interventions and comparison groups in the articles strongly compare to those identified in the PICOT question. A thorough discussion on the method of study for each article is presented. The comparison of study methods is described in detail. A benefit and a limitation of each method are presented. The discussion demonstrates a solid understanding of research methods. Discussion of study results, including findings and implications for nursing practice, is thorough with substantial relevant details and extensive explanation. Discussion of ethical considerations associated with the conduct of nursing research is thorough with substantial relevant details and extensive explanation. A detailed discussion on ethical considerations of the two articles used in the essay is presented. Comments Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. Argument is clear and convincing and presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. Writer is clearly in command of standard, written, academic English. All format elements are correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error NRS 433V Ethical Considerations Essay