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Health Care Topic of Interest-Evidence Based Paper

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Scientific research as a systematic process requires specific procedures that make the outcome acceptable and credible. The paper will analyze two research evidence sources conducted by Hedman et al., (2013) and Stopa et al., (2013). The first one is quantitative, and the second one is qualitative.

Hedman et al., (2013) conducted a study to determine the relationship of internal shame, self-reproach, depressive signs, and social anxiety. The background and introduction to the research study provide an overview of Social anxiety disorder. The researcher indicated the disease as an overwhelming fear of being criticized by others and evading of social actions that arouse this concern. The researcher note in the background that the disorder is one of the common cognitive illnesses and connected with significant injury and an increased risk of raising other emotional problems. The researchers still discussed the features of anxiety in the background, and they include factors such as the fear that prevents an individual from acting. The history also presents aspects of social anxiety and Social anxiety disorder linked to fear. The researchers also defined fear in the background as the influence involving opinions that others interpretation oneself as developing negative individual individualities or engaging in unwanted behaviors. The human complex ability of imagination creates the feeling in the mind of an individual.

Previous research indicates in literature review illustrate what other researchers have done on this topic. Researchers like Fergus et al. and Gilbert explain that that internal shame is linked to the social anxiety. The researchers used the Test of Self-Conscious Affect to determine the relationship between the two variables. Matos et al. also discovered the same results in their study. These studies the researchers revealed that internal and external shame were moderately associated, and guilt was unrelated to the significant influence of shame in an individual. Fergus et al. discovered that there was a negative connection between the two variables. The researchers noted that very limited information had been obtained on the relationship between internal shame and Social anxiety disorder. Even though, one study has indicated challenging situations that contribute to establishing a relationship between the two study variables (Hedman et al., 2013).

Cognitive behavior therapy (CBT) can be used to treat the SAD, which has proved its effectiveness in 20 randomized controlled trials. Although, research on the approaching effect on internal shame in the treatment of Social anxiety disorder is scarce, and one study indicated that people experiencing anxiety disorder undergoing the treatment for two weeks indicated reductions of shame controlled social anxiety and the improvements. The researchers did not find findings on the effect of individual CBT for Social anxiety disorder on shame. Additionally, no study has investigated where the treatment approach has an individual or group format, moderates the association of guilt and outcome in CBT for Social anxiety disorder (Hedman et al., 2013).

The researchers made two types of comparison. First, the researchers compared the experience of shame using a case-control design in a sample of patients with Social anxiety disorder to sample of health control consisting of 72 respondents. After analysis of data, a sample of twenty respondents was recruited, and the sample was well matched to the demographic characteristics of those surveyed (Hedman et al., 2013).

The respondents were obtained from an outpatient clinic, and the main inclusion was that the participants must have experienced Social anxiety disorder and diagnosed using the DSM-IV. The respondents were between the ages of eighteen to sixty-five. Students from nearby learning institutions were used as healthy controls, and they were recruited on two separate occasions.  Through statistical analysis, the power to establish the dissimilarity between the scientific test and the in good physical shape control clusters was considered sufficient. Therefore, the researchers used ninety-four participants in the control group. Another sample was recruited from the psychology or psychotherapist program to improve their findings in the demographic characteristics of the disorder. Results in this group of participants indicated significant differences between social anxiety disorder respondents and the in good physical shape control respondents regarding their age and gender.  However, the researchers discovered that there were no significant dissimilarities between the social anxiety disorder respondents and the in good physical shape control group respondents on these research variables (Hedman et al., 2013).

In the data analysis, the researcher measured the relationship between Shame and guilt. They also measured the correlation between shame, guilt, social anxiety and depression and the effect of CBT. Finally, treatment measured the effect of treatment approaches on the connection between shame and social anxiety. The study concluded that there was the relationship between shame and social anxiety is moderately complicated because shame and social anxiety are not substitutable concepts in the initial sample. Findings indicated that shame was elevated with the person suffering from social anxiety disorder (Hedman et al., 2013).

The evidence presented in every section of the study supports the researcher’s conclusion because the introduction provided a brief overview of the problem. The literature review discusses what other researchers have conducted on the topic illustrating the knowledge gap. The methodology describes the research procedures used to test the relationship between the variables under investigation. The data analysis discusses the different measures used in the analysis process to determine the relationship between research variables (Hedman et al., 2013).

The article did not provide an explanation of how they protected the writs of the study participants though the participants were drawn from a medical learning institution and social anxiety disorder clinic. In addition to this, the study limitation includes the participants used in the first experiment were not matched based on the age difference and gender distribution. However, the important strength was the inclusion of a repetition sample that resembled the scientific sample regarding demographic features that enabled a complete analysis. Another limitation of the study was the use of the relatively small sample, which reduced the power to identify any variation between the research variables (Hedman et al., 2013).

Lastly, evidence obtained in this study will help in improving the different treatment procedures used in treating social anxiety disorder among people. The study is also the first to demonstrate that Cognitive behavioral therapy successfully reduces deep shame in the healing of Social anxiety disorder. It will also form a basis for future research on Social anxiety disorder and the effects of different treatment procedures in treatment. Other researchers will use the study findings to develop background information in their research on Social anxiety disorder.

Stopa et al., (2013) conducted a qualitative analysis of social threat in societal fear and paranoia. The background of the study indicates how the cognitive models explain how people with social phobia and paranoia share a common fear of others. These researchers have recognized the clinical difference though it is likely that some of the psychological factors contribute to the increase in the disorder. However, the nature of these differences is not clearly understood. Therefore, the researchers explored the fears occurrences in individuals with social anxiety and persecutory illusions to explain these characteristics of the different cognitive representations (Stopa et al., 2013).

The researchers explored the accounts of social threat occurrences in nine research participants with social paranoia and nine respondents suffering from persecutory hallucinations. The researchers then conducted a verbatim transcription, and the information was analyzed using thematic analysis. Findings from the analysis indicated that the research participants' occurrence of fear, responses while under intimidation, and succeeding reflections. The use of Narrative coherence appeared to be the dominant theme. Three themes were developed from the analysis respondents’ experience of fear, responses while experiencing the threat, and subsequent reflections. The narrative coherences were shown as a superordinate subject the researchers also discovered common fear among the respondents in both groups. The main difference was recorded in respondents perceptual understandings, the ability to be strong the threat after an event, and the narrative consistency. The differences were noted in their capacity to react to different threats in the environment (Stopa et al., 2013).

 Finally, the study findings were discussed based on the cognitive model's social phobia and paranoia. The researcher made a conclusion on the theoretical and clinical implications. They concluded that there was the need for medical researchers to examine attention and metacognitive procedures thoroughly if people want to comprehend the maintenance of apparent threat in these groups of participants, and ways of easing the associated pain. They also recommended more research to determine some of the ways nurses can use to reduce the distress associated with the disorder (Stopa et al., 2013).

Pieces of evidence presented in each section of the article do not provide a comprehensive support of the researcher’s conclusion. The background only provides very limited information on the topic, which in turn provides the readers with limited background on the research topic. Little information is provided in the literature review concerning what other researchers have conducted to bring out the knowledge gap. A comprehensive detail in the methodology section is not provided. Therefore, it is not clear to determine what the researchers used in the research including the research participants and how they were selected for the study. Data analysis procedures were not described in detail, and the researchers just mentioned they conducted an examination of interpersonal threat experiences in nine respondents who have social phobia and another nine from people suffering from persecutory delusions, as well as the performance of verbatim transcripts using thematic analysis, which makes the study qualitative in nature. More information was to be provided to explain how qualitative research was used in this study. Sampling procedures should have been recorded to indicate how the researchers obtained their nine participants for the two groups.

These researchers never provided a detailed explanation on how they protected the research participants and how they considered the cultural backgrounds of the research participants. Ethical consideration is necessary for any investigation process because it helps one understand how the research participants were protected from the study effects. In addition to this, the most significant strength of the research study is that it provides findings on the relation of contemporary cognitive representations of social phobia and paranoia. The results obtained from the analysis also provide theoretical as well as clinical implications of the disorder. Findings in the study also help other clinical researchers in making conclusions on the use metacognitive processes in understanding the maintenance of perceived threat in the two groups of research participants.

The researchers used a limited sample of research participants, which makes it difficult to have limited power to differentiate the findings obtained between the two variables. To determine a significant difference in analysis, the researchers need to use a larger sample representation. Furthermore, the limited sample size lowered the reliability of the study. The sample size also contributed a small number of information obtained from the study participants because of the more, the larger the sample size, the more the researchers get a lot of information in their study.

Evidence obtain in this research will help the nursing profession on how to use the cognitive models to assess people suffering from social phobia and paranoia showing some of the characteristics they share in common. The nursing profession will use the findings obtained in the study to help patients suffering from social phobia and paranoia. Nurses will also use the research study results to describe some of the conditions that contribute to the disorder in people. Other nursing scholars will use the findings obtained in this study to develop the background of their study and literature review on topics related to the social phobia and paranoia. Finally, information gained in the investigation will help in treating people suffering from social phobia and fear in different clinics across the world.

In conclusion, the two articles presented research conducted in a systematic manner to investigate the conditions people experience and some of the ways used to treat the conditions. These studies have strengths and limitations, but the findings can be said to be credible because they underwent a systematic scientific process to prove their conclusions.

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