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Research Article Appraisal Assignment–Quantitative
For this assignment, use the article you found for your week two discussion post.
1. Type your PICOT Question below this line.
In community mental health patients (P), how does exercise along with medication (I), compared to medication alone (C) reduce depressive symptoms (O), within 6 months (T).

2. Type your properly APA-formatted reference citation below this line.

Diegelmann, M., Jansen, C.-P., Wahl, H.-W., Schilling, O. K., Schnabel, E.-L., & Hauer, K. (2017). Does a physical activity program in the nursing home impact on depressive symptoms? A generalized linear mixed-model approach. Aging & Mental Health, 22(6), 784-793. https://doi.org/10.1080/13607863.2017.1310804
3. Referring to the hierarchy of evidence in Chapter 15 of your text, the type name of the research design and the level of evidence it represents below this line.
A quantitative randomized controlled trial with a level II level of evidence.
4. Complete the table below. See the rubric for grading criteria. Specific detail and examples must be provided in the third column to meet the intent of this assignment.
Critical Appraisal Item Yes, No, Partially Explanation/Justification/Rationale
General
Does the article answer the same question as your picot question? Partially The article relates to our group’s PICOT question. The article is a study of participants in two separate nursing homes and the effects of physical activity programs and the impacts of these programs on depressive symptoms.
Is the journal peer-reviewed? Yes The Davenport University library states this article is peer-reviewed.
Is the article recently published (within 5 years)?* Yes The article was accepted March 19, 2017, and published on June 1, 2018.
Article Introduction
Do the authors demonstrate a need for the study? (ie, what is the research gap?) Yes Addressing shortcomings of previous research, the authors examined the effect of a physical activity intervention program on nursing home residents’ depressive symptoms using a generalized linear mixed model approach.
Do the authors clearly state the purpose of the study? Yes To understand the effects of physical activity programs on nursing homes and the impact the programs will have on depressive symptoms.
If applicable to the design, are hypotheses stated? Yes The article has the hypotheses stated in the hypotheses section of the article.
Do the authors clearly state a hypothesis or the purpose of the study? Yes The authors expect decreased depressive symptoms in participants who participated in the physical activity interventions. They also expect increased depressive symptoms in non-participating residents.
Methods
Is the study design valid for the question being asked/purpose of the study? Yes
Was the protection of human subjects considered? Yes All participants were provided written informed consent. Ethical approval was obtained from the Ethic Review Board of the Facilty of Behavioral and Cultural Studies at Heidelberg Unversity. Also, the study conformed to the policy and mandates of the Declaration of Helsinki.
Are the details of data collection clearly and logically presented? Yes
Is there an attempt to limit bias in the selection of participants? (Consider: method for sampling, sample size, attrition) Yes
Are the instrument(s) described sufficiently in terms of content, structure, validity, and reliability? Yes
Are the outcome measures valid for the picot question you are researching? Yes This article further validates that physical activity in depressed patients can improve patient outcomes. Non-participants in the physical activity aspect of the study depressive symptoms increase. Whareas participant’s depressive symptoms were maintained.
Results
Are there limits to generalizability of the results (external validation)? If so, describe. Yes All participants in the study were members of the geriatric population, and the selection of participants came from members of two nursing homes. External validity limits are effects of selection, the interaction of treatment and setting, and interaction of treatment and selection of subjects.
Are the results presented within the paper and in tables? Yes
Are the results statistically significant? How large is the difference between groups (if applicable). Yes Participantsincreasing in physical activity (n = 78) and non-physically active participants (n = 85) showed comparable depressive symptoms at the pretest. The participants who exercised had depressive symptoms that stabilized between pretest, posttest, and follow-up. The non-exercising group showed an increase in depressive symptoms.
Discussion/Conclusion
Is the evidence sufficient to draw conclusions? Yes Implementing a physical activity program appears to prevent the increase of depressive symptoms in nursing homes. Generalized linear mixed models seem to be a promising tool for intervention research.
Are the conclusions and generalizations clearly stated?
Do the authors discuss the clinical significance of the outcomes? Yes Participants who participated in the study support that a pChallenginghysical activity positively impacted residents’ depressive symptoms. Whereas nonparticipants’ depressive symptoms increased across nine months, participants for Facultywho we included pretest levels were maintained.
Does the study contribute to nursing knowledge? Yes The study contributes to nursing knowledge by management of symptoms in the geriatric population and enhancing end-of-life care through implementing physical activity to decrease depressive symptoms.
Do the authors discuss the limitations of the study? If so, what are they? Yes Challeging to include all residents in the real world of nursing home ecologies using RCT design. The authors could not rule out that an unmeasured covariate influenced whether or not residents participated. A casual effect could not be claimed. Also, the authors used a dimensional scale rather than a clinical measure of depression, hence the words depressive symptoms rather than the word depression.

I need help with the methods section, one result, and one conclusion question. Please disregard spelling errors. This is the rough draft. Any help will be appreciated.
I am needing some help finding answers to the methods section, can you please tell me where or how to get this information from the reference included. Thank you

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