How to Answer What Design Setting Questions (Complete Guide)

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Structure your response with introduction, analysis, and conclusion.

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Original Question

What is the design, setting, sample inclusion criteria, Data collection process, instruments used in the below study? Objective Nurses working in adolescent health often lack educational opportunities to develop their knowledge and practical skills to address the challenges faced by adolescents and young adults. This integrative review synthesised the evidence from peer-reviewed research that focused on educational programs to improve nurses’ knowledge, attitude, and practice in adolescent and young adult health. Design The five-stage framework by Whittemore and Knafl guided the integrative literature review and was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. Data sources A single search strategy was replicated across five electronic databases (CINAHL Plus, APA PsycInfo, PubMed, Scopus, and ERIC). Studies of educational interventions or training programs for nurses on adolescent and young adult health, published in English in the last 10 years were included. Review methods All studies found were reviewed for relevance independently by two authors, who likewise critically appraised the quality using the “Critical appraisal checklist for an article on an educational intervention” adapted from Morrison et al. (1999), with a third author providing consensus. Data were extracted using study specific standardised proforma and thematically analysed. Results Seven studies met the inclusion criteria. Topics covered included cancer care, mental health and self-harm, with only one program including general adolescent health. A mix of face-to-face and digital asynchronous mode of delivery was employed in these programs with multi-strategic approaches used to enhance accessibility and engagement. While all studies reported improvement in knowledge and practice, including enhanced communication skills, some studies reported limited change in attitude. Success of the interventions was attributed to the flexibility of programs to accommodate nurses’ workloads. Conclusion Education interventions for nurses delivering care to adolescent and young adults enhance knowledge and skills, however, programs with institutional support for flexibility and accessibility are needed to influence a positive change in attitude. 1. Introduction Adolescent health is often overlooked as a nursing subspecialty partly because young people are generally a healthy sub-population. Yet adolescents constitute one-sixth of the world’s population (World Health Organization, 2021) and during this transitional phase of development, they often experiment and take risks with alcohol and other drugs and with their appearance and social activities, as they seek to create their identity and become independent from family (Willoughby et al., 2014). Nurses, particularly those working in mental health, have expressed concerns about safety and whether appropriate care is being given to young people in paediatric wards (Thomas, 2017), highlighting adolescents and young adults may require a different approach to care than they are currently provided during hospitalisation (Smith, 2004). Nurses working in this area often lack educational and clinical practice opportunities to develop their knowledge and skills to address the challenges faced by adolescents and young adults (World Health Organization, 2019). 2. Background Educational programs can potentially improve knowledge, attitude, and skills and allow healthcare professionals, including nurses, to identify areas of knowledge deficit and learning needs (Calzo et al., 2017). Often when educational programs are developed in collaboration with healthcare professionals, they are found to be more effective in increasing knowledge and confidence, and are reportedly more satisfying to undertake than programs designed exclusively by academics or educators (Bray et al., 2013; Manning et al., 2015). The World Health Organization (2015) has highlighted the significance of building an adolescent-competent workforce through pre-service and continuous professional development programs by focusing on factors that make adolescents unique. Such programs are seen to enhance attitude, increase knowledge, and raise competency levels in healthcare staff (Coad et al., 2018). Therefore, it is necessary for nurses to be aware of issues currently facing adolescents and increase their knowledge and skills by providing further professional development to improve age-appropriate care (Kokotailo et al., 2018). 3. Method 3.1. Aim This integrative review synthesised the evidence from published peer-reviewed research that focused on educational programs to improve nurses’ knowledge, attitude, and skills in the area of adolescent and young adult health. 3.2. Design The five-stage framework by Whittemore and Knafl (2005) guided this integrative review. The stages include problem identification, literature search, data evaluation, data analysis and presentation of the results. This review type was chosen as it does not exclude studies based on study methodology and is enhanced by a quality appraisal process. This methodology contributes to a comprehensive understanding of a phenomenon of interest by evaluating the strength of the evidence, making comparisons, identifying the gaps and need for future work (Whittemore and Knafl, 2005). 3.3. Inclusion and exclusion criteria In mid-January 2022 a systematic search was conducted for peer reviewed studies published in English over the last 10 years, to identify research that focused on educational interventions or training programs for nurses related to adolescent and young adult health. No restrictions were placed on the study designs with both quantitative and qualitative studies included. No limitations were placed on study quality or location. Study protocols, grey literature, conference abstracts, opinion pieces, systematic/literature review papers and discussion papers were excluded. Studies designed for undergraduate and postgraduate nursing students and those where nurses were not a discrete sample were also excluded. 3.4. Search methods In consultation with a university librarian, systematic searching of five electronic databases was undertaken using a combination of key search terms and medical subject headings (MESH): APA PsycInfo, PubMed, Scopus, ERIC and CINAHL Plus. The search included a combination of key and MESH terms (MH) depending on the database. An example of the search terms from two of the databases with the most returns is provided. PubMed search terms included: “Nurses”[Mesh] OR “Nurs*” AND “Competency-Based Education”[Mesh] OR “Nurse Education” OR “Training Program” AND “Adolescent Health”[Mesh] OR “Adolescent Health” OR “Young Adult”. APA PsycInfo search terms included: (MM “Nurses”) OR “Nurs*” AND (MM “Nursing Interventions”) OR (MM “Nursing Skills”) OR (MM “Education, Nursing, continuing”) OR (MM “Education, Nursing”) OR (MH “Professional Development”) OR Education OR “Educational Intervention” OR “Nurse education” OR “training program” OR professional development OR “Continuing professional development” OR “continuing education” AND (MM “Adolescent Health”) OR (MM “Young Adult”) OR “Adolescent Health” OR “young people”. 3.5. Search outcomes A total of 1098 articles were retrieved by one member of the review team (EK). Forty-four duplicate articles were then removed. Two reviewers (EK and LR) then screened the remaining 1054 articles by title for eligibility leading to the exclusion of a further 977 articles. The remaining 77 articles were then screened by abstract for eligibility by a team of four reviewers (EK, LR, DM, PL) leading to the exclusion of a further 59 articles. The full-text of the remaining 18 articles were then reviewed by three members of the review team (EK, LR, DM) to ensure eligibility; a further 11 articles were excluded, as on closer review five included a mixed group of healthcare professionals, two were not adolescent health interventions/programs, one was a protocol, two provided details of a program or program development (no evaluation) and one was a duplicate. Finally, seven studies met the inclusion criteria for this review. 3.6. Quality appraisal Each eligible study was independently appraised by two reviewers (EK, DM) using an adapted version of the “Critical appraisal checklist for an article on an educational intervention” developed by Morrison et al. (1999). Consensus of scores on an item/s was not reached for any study so a third reviewer (LR) made the final determination on score. Each criterion met in the checklist was scored one point, including not applicable items and the final score for each study was presented as a percentage. Quality ratings were: 80-100 % (strong), 60-79 % (moderate) and <60 % (weak). All seven studies were rated strongly (Table 1). 3.7. Data abstraction and synthesis Data from the 7 studies were extracted into a summary table (Table 2) for analysis with the following headings: Author, Year, Country, Quality Score; Aim, Study Design, Participants; Program Features; Findings and Outcomes; Strengths and Limitations. While the initial extraction process was undertaken by one researcher (EK), the final studies were distributed to another 3 members of the team (DM, LR, PL) for a final cross-checking and validation of the extracted data with an opportunity to edit, amend, or augment contents (if necessary). The final data were synthesised and clustered into three main categories for further evaluation. The three categories were: 1) Program characteristics; 2) impact on knowledge, attitude, and practice and 3) success factors and recommendations.

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