Healthcare Workers and Trial

¶ … Therapist differences in a randomised trial of the outcome of cognitive behaviour therapy for health anxiety in medical patients." It was authored by Tyrer et al. and appeared in the International Journal of Nursing Studies in 2015. Did the trial address a clearly focused issue? After thoroughly anatomizing this article it is clear that the trial described within it certainly did address a clearly focused issue.

Specifically, the authors were looking to determine which group of healthcare practitioners was best suited to assist patients with health anxiety through the usage of cognitive behavior therapy. In particular, the authors were looking to discern whether or not nurses nurses could demonstrate a greater efficacy for this task than other groups of medical practitioners.

Therefore, the authors utilized original research in the form of a randomized clinical trial to see if nurses could prove they had such effectiveness with this particular issue: that of successfully implementing cognitive behavior therapy for patients who were afflicted with some form of health anxiety. 2. Was the assignment to patients to treatments randomized? Absolutely, the assignment of patients to treatments was entirely randomized. The researchers were able to produce this effect firstly by pooling all of the patients from a homogeneous source.

They were taken from various medical centers throughout England and were seen for a variety of different events. Moreover, the researchers deployed to the two branches of the study via block randomization generated from a computer sequence in which "The allocation sequence was not available to any member of the research team until databases had been completed and locked" (Tyrer et al., 2015, p. 688). Thus, it is clear that the randomization of patients was entirely impartial and quite effective in this regard. 3.

Were all of the patients who entered the trial properly accounted for at its conclusion? There were a fair amount of patients who entered the trial who were not properly accounted for at the conclusion of he aforementioned research paper. The vast majority of the patients who were not accounted for were not mentioned. There was little more than a cursory explanation for these patients. According to the researchers (2015) 445 patients were randomized to the trial and 376 (76%) completed the follow-up after two years" (p. 689).

The reader is largely left to the infer that the majority of the 24% which did not complete the trial simply declined to participate once the trial began. The best attempt made to explain this fact is that of the patients randomized to the therapist group, "15 therapists did not respond for treatment after randomisation and 6 more did not attend initially but did have some form of contact later" (Tyrer et al., 2015, p. 689). 4.

Were patients, health workers and study personnel 'blind' to treatment? The patients were certainly blind to the treatment or the control group. The healthcare workers were equally blind to this fact. They received training on how to implement cognitive behavioral therapy, but were not appraised of the overall study design and the control involved. However, the study personnel were not blind to the treatment, since they were the ones how devised the study and required cognizance of it to assess their hypotheses. 5.

Were the groups similar at the start of the trial? The groups were identical in every way possible at the start of the trial. In fact, the researchers took several measures to include the fact that there was no differences between the two groups. The entire population for this study was pooled from those attending out-patient clinics for a variety of areas of assistance, including cardiology neurology, and others. Moreover, they were pooled from six different hospitals in different parts of England (Tyrer et al., 2015, p. 687).

Still, the crux of the absolute parity found between the two groups lies in the way in which they were randomized, which further corroborates the equality between them. They were randomized according to an impartial computer program "in a 1:1 ratio to the two arms of the study according to a computer-generated random sequence using block randomization" (Tyrer et al., 2015, p.688). 6. Aside from the experimental intervention, were the groups treated the same? The groups were unequivocally treated the same in this study, aside from the experimental intervention.

The researchers were able to ensure the equitable treatment of them by simply having the control not experience any sort of cognitive behavioral therapy whatsoever. On the other hand, the other group received multiple sessions of this form of therapy. Furthermore, both groups were issued follow up information at the same point in time, which was the principal means in which the researchers were able to determine the results of their study.

This follow-up information provided by the two groups helped to distinguish the effects of the form of treatment (and lack of treatment for the control) each group received. 7. How large was the treatment effect? The treatment effect was considerable. It certainly was noticeable between the two groups. The authors conveyed this fact in a couple of eminent ways. They demonstrated it verbally by stating "The primary outcome in the main trial was the change in HAI scores after 1 year.

This showed a...significant benefit for CBT-HA in the main trial...but when the results were separated by therapist type it was clear that the largest component of this component came from the nurse-treated therapists" (Tyrer et al., 2015, p. 689). Solid statistical results indicate this fact as well, as after a year the difference between the pair of groups was 2.98 with a confidence interval of 95% and 1.64-4.33 difference between the groups as well (Tyrer et al., 2015, p. 689). 8.

How precise was the estimate of treatment effect? The precision of the estimate of treatment effect was commendable. There was a 95% confidence interval reflected in the results between the overarching distinctions between the standard care group and the one receiving cognitive behavioral therapy (Tyrer et al., 2015, p. 689). Moreover, those results demonstrated a greater efficacy in reducing health anxiety with the cognitive behavioral therapy group than that for the control. 9. Can the results be applied to your context? The results can be cautiously applied to my context, to a limited extent.

The research makes it appear as though the nurses were much better at getting higher results from their patients, which in this study translates to decreasing the patients' health anxiety as demonstrated by a couple of key factors including social functioning and hospital anxiety. Based on these results it seems as though the deployment of cognitive behavioral therapy is a viable option for.