Weightloss Counseling and Physical Exercise PHASE II Search Paper

Scholarly Project

Dana Delatush RN BSN ONC

"I pledge my honor that I have neither given nor received inappropriate aid on this assignment."

Abstract Comment by Patricia: Place the abstract on a separate page for your final search paper

This paper is focused on the literature search related to the PICOT question: Does weight loss counseling and physical exercise improve pain and mobility in obese patients with a BMI >25 suffering from osteoarthritis? To answer this clinical question, six databases were searched including the Cumulative Index of Nursing and Allied health Literature (CINAHL), The Cochrane Library, PubMed/Medline, Google Scholar, PsycInfo®, and ProQuest Nursing and Allied Health Source™. The paper describes the search methodology. Keywords: osteoarthritis, obesity, weight loss counseling, pain, mobility

Introduction to Search Strategy

I will be creating a search strategy to help me clarify what information I need, and what keywords can be used to yield relevant information. The search strategy I will articulate will result in precise and refined outcomes of many relevant articles. The first step in my search strategy is to define my topic in a complete phrase or sentence. This was accomplished through the development of the PICOT question. PICOT Question: Does weight loss counseling and physical exercise improve pain and mobility in obese patients with a BMI >25 suffering from osteoarthritis? Next, I identified the keywords that I will use at the beginning stage of the search: Comment by Patricia: Avoid using the first person in scholarly writing

Osteoarthritis, obesity, weight loss counseling, physical exercise, reduce pain, increase mobility, BMI >25. Then, I identified some synonyms for the keywords listed above: Comment by Patricia: Comment by Patricia: Lists are not appropriate for this paper. Use paragraph format

Osteoarthritis: arthritis, swollen joints, painful joints, autoimmune disease

Obesity: overweight, body mass, BMI>25, fat

Weight loss counseling: diet, nutrition, guidance

Physical exercise: activity, fitness, flexibility

Reduce pain: comfort, anti-inflammatory, painkiller

Increase mobility: daily living, ambulation, independence

Additional considerations included decisions that I needed to make about the following:

Would I exclude any languages or include any particular languages? I determined that I would only use the English language in my searches. Comment by Patricia: Questions you asked yourself should not be included. Parameters you set for the search should be identified

Would I use controlled vocabulary? I determined that I would not use controlled vocabulary since I would be reviewing articles from researchers and felt this limitation would constrain my search.

How would I define my inclusion and exclusion criteria? I had determined that the articles needed to be scholarly, no older than five years, be available in full text format, be peer-reviewed articles from a juried journal, and written by practitioners or researchers.

Did I have any ideas at this stage in the search about any limits that I might set? I decided to use the functions in the CINAHL search platform to determine any limits, and assumed that I would quickly learn how well this was working after a few search attempts. If I needed to further articulate limits, I decided I would do so further into the study.

Would I search for grey literature? I decided that I would search for grey literature, as I was particularly interested in any current working papers from research groups on my topic. It was here, I thought, that I might best learn about innovative practices that were not yet mainstream.

I next moved on to finding the CINAHL headings and subject headings for my keywords and synonyms. After watching a Elton B. Stephens Co. (EBSCO) tutorial on the process (http://support.ebsco.com/training/flash_videos/cinahl_mesh/cinahl_mesh.html), I followed the steps outlined below.

Step 1: Defining Concepts

Step 2: Finding CINAHL Headings

Step 3: CINAHL Heading Options

Step 4: Adding the Heading to the Search

Step 5: Adding More Concepts to the Search

Step 6: Combining Search Terms

Step 7: Refining Results with Limits (Optional) Comment by Patricia: The step-by-step approach you used, while essential to a thorough search, should not be included in this paper. It is assumed that you did this.

As I built the list of documents to review, I considered the requirements for the articles that I would focus on to conduct my research. Moreover, I wanted to be sure to search within at least five different databases to ensure my initial search was comprehensive,...

The databases I decided to search include the following:
CINAHL

Google Scholar

MEDLINE

Proquest Nursing & Allied Health

PsycINFO

PubMed

The Cochrane Library

At this point, I was ready to commence my search. Once I had compiled a good collection of articles, I applied the rapid critical appraisal strategy to the articles. This means that I selected six research studies that I belief provide the best evidence to support the implementation of my project. Comment by Patricia: Again, no need to describe the step-by-step

I made a reference sheet to guide me in my efforts to select articles that were represented the levels of hierarchy of evidence that I felt I needed to ensure a robust search of the literature. I used the following definitions of Levels I through VII: Comment by Patricia: No need to reiterate the levels here

Level I Evidence from a systematic review of all relevant randomized controlled trials (RCTs) or evidence-based clinical practice guidelines based on systematic reviews of RCTs.

Level II Evidence obtained from at least one well-designed randomized controlled trial (RCT).

Level III Evidence obtained form well-designed controlled trials without randomization, quasi-experimental.

Level IV Evidence from well-designed case-controlled and cohort studies.

Level V Evidence from systematic reviews of descriptive and qualitative studies.

Level VI Evidence from a single descriptive or qualitative study.

Level VII Evidence from the opinion of authorities and/or reports of expert committees.

I marked each article that I printed out with the level of the hierarchy of evidence so that I would have ready access to the information when I was ready to record the information on the evaluation table in Phase III.

Search Results: Comment by Patricia: No lists. Report how many articles you found from each database. List the articles on the reference page

PubMed

Do, B., Hootman, D., Helmick, C.G., & Brady, T.J. (2011). Monitoring healthy people 2010 arthritis management objectives: education and clinician counseling for weight loss and exercise. American Family Medicine, 9(2), 136-141. doi: 10.1370/afm.1210 Retrieved http://www.ncbi.nlm.nih.gov/pubmed/21403140

Fineout-Overholt, E., Hofstetter, S., Shell, L., & Johnston, L. (2005). Teaching EBP: getting to the gold: how to search for the best evidence. Worldviews Evidence-Based Nursing, 2(4), 207-11. Comment by Patricia: Did this article come from your search of PubMed? This is an excellent reference for the paper. List on reference page

Fontaine, K.R., Haaz, S., & Bartlett, S.J. (2007). Are overweight and obese adults with arthritis being advised to lose weight? Journal of Clinical Rheumatology, 13(1), 12-15. Retrieved http://www.ncbi.nlm.nih.gov/pubmed/17278942

McInnis, K., Franklin, B.A., & Rippe, J.M. (2003). Counseling for Physical Activity in Overweight and Obese Patients, American Family Physician, 67(6), 1249-1256. Retrieved http://www.aafp.org/afp/2003/0315/p1249.html Comment by Patricia: Lowercase rule

Sartori-Cintra, A.R., Aikawa, P., an&d Cintra, D.E. (2014). Obesity vs. osteoarthritis: beyond the mechanical overload. Einstein (Sao Paulo), 0:0. [Epub ahead of print] Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/25184806

MEDLINE

Sowers, M.R. And Karvonen-Guiterrez, C.A. (2010, Sept.). The evolving role of obesity in knee osteoarthritis. Current Opinions Rheumatology, 22(5), 533 -- 537. doi: 10.1097/BOR.0b013e32833b4682. PMCID: PMC3291123. NIHMSID: NIHMS358648

Stillwell, S.B., Fineout-Overholt, E., Melnyk, B.M., & Williamson, K.M. (2010). Evidence-based practice, step-by-step: asking the clinical question: A key step in evidence-based practice. American Journal of Nursing, 110 (3), 58-61. doi: 10.1097/01.NAJ.0000368959.11129.79 Comment by Patricia: Did this article come from your search of PubMed? This is an excellent reference for the paper. List on reference page

PsychINFO

Cushing, C.C. And Steele, R.G. (2014). Evidence-based obesity management for primary care. Public Interest Directorate. American Psychological Association. Retreived from http://www.apa.org/pi/families/resources/primary-care/obesity-management.aspx?item=1

Google Scholar

Edwards, C., Rogers, A., Lynch, S., et al. (2012). The effects of bariatric surgery weight loss on knee pain in patients with osteoarthritis of the knee. Arthritis, 2012, [Clinical Study]. http://dx.doi.org/10.1155/2012/504189 Comment by Patricia: How many authors? See APA format for citing multiple authors

BioMed

Paans, N., van den Akker-Scheek, I., van derMeer, K., Bulstra, S.K. & and Stevens,…