Assignment: Keeper Study ESSAY

Assignment: Keeper Study

Assignment: Keeper Study

PICOT Clinical Question: Among depressed teens in the urban area, is the use of exercise therapy in comparison to bibliotherapy result in better disease remission within six months?

Select Article: Yuan, S., Zhou, X., Zhang, Y., Zhang, H., Pu, J., Yang, L., … & Xie, P. (2018). Comparative efficacy and acceptability of bibliotherapy for depression and anxiety disorders in children and adolescents: a meta-analysis of randomized clinical trials. Neuropsychiatric disease and treatment, 14, 353. DOI: 10.2147/NDT.S152747.

Reasons for the Study

Depression and anxiety are singled out as the most common mental health disorders that readily affects children and adolescents. Different approaches including pharmacotherapy and non-pharmacotherapy options exist to manage mental illnesses for the different age groups. The study in the selected article identified the use of bibiotherapy in the treatment of depression among teenagers and how the therapy option result in disease remission (Yuan et al., 2018). Bibliotherapy is a form of psychological treatment which aim at encouraging patients to change unhelpful thoughts and behaviors that causes depression. Bibliotherapy result in improved self-management and reduces the impact of stigma associated with depression. This study is relevant to the PICOT clinical question as it analyzes bibliotherapy option of care to help in developing a comparison with exercise therapy to guide decision on implementation of the best approach of care for teenagers with depression.

Sample Size

The article was based on a selection of eight studies which comprised of 979 participants. The participants were children or adolescents (aged 6 to 18 years) and these were enrolled in the primary study (Yuan et al., 2018). The selected group had a diagnosis of anxiety or depression and must have exceeded a predefined threshold as per the author’s definition of anxiety or depressive symptoms. The sample group was randomly selected and a comparison of the bibliotherapy was made against a control group with no treatment. However, studies were excluded if bibliotherapy was not implemented for the treatment of depression or anxiety. Nonetheless, study articles met the inclusion criteria if they included adolescent patients with comorbid mental health disorders in addition to depression or anxiety. The retrieved articles were relevant to the PICOT clinical question as they resolved divergences related to the non-pharmacotherapy of depression in teenagers.

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Clarity and Reliability of the Instruments of the Study

Instruments of the variable used in the research were clearly defined and were reliable to address the PICOT clinical question.

The researcher independently identified the parameters for depression and anxiety among the target population. Data were extracted using the PRISMA guidelines whereby five relevant databases were used to predict the patterns of the study outcomes (Yuan et al., 2018). These databases included Embase, Web of Science, PubMed, PsycINFO and Cochrane. Ideally, outcome related to the use of bibliotherapy in managing depression for the teenagers was clearly defined. This mainly focused on treating depression or anxiety and prevention of relapse after therapy. The outcomes from the aforementioned databases varied based on the settings or clinical condition of the patients and this reflected the impact of bibliotherapy in addressing patients diagnosed with depression.

Analysis of Data

Data from different databases were analyzed using the DerSimonian and Laird random-effects model for the interpretation of meta-analysis. Using this framework, the heterogeneity of the outcomes were evaluated using the Q statistic and I² statistic to estimate the variation in side effects. However, risk ratios (RRs) was used in the analysis of dichotomous measure outcomes for the treatment of the teenagers in the intervention that incorporated bibliotherapy (Yuan et al., 2018). Nonetheless, publication bias of the selected articles was examined using the funnel plot method as well as the Egger regression asymmetry test.

Unusual Events during the Study

No unusual event was noted considering that the research involved the analysis of peer-reviewed literature materials. Due to this, no consequences will be identified in case the researcher intends to replicate the study. In other words, the variables of the study will remain unchanged and the intended outcomes of behavior change guides the implementation process for the replicated study (Yuan et al., 2018). However, the setting for the replication of the study is likely to change considering that the approach may be applicable to different population group or gender in a bid to address depression.

How results fit in with previous research in the area of study

The outcomes fit in previous research as it focuses on the intention to treat population understudy. The results build on findings from other studies about the non-pharmacotherapy options in providing care to patients diagnosed with psychiatric problems. Since the analysis incorporated findings from bibliotherapy studies, it was possible to predict the positive treatment outcome using the approach (Yuan et al., 2018). The experiences of the target population were also consistent with findings presented by other researchers to affirm the benefits of using bibliotherapy for depression or anxiety in adolescent patients.

Implications of the research for Clinical Practice

Findings revealed bibliotherapy as an effective psychotherapy option in managing depression among adolescents. However, the long-term effects of the therapy is unjustifiable implying that the approach cannot be used as a standalone method in addressing anxiety or depression among teenagers. Besides, the level of support of bibliotherapy for clinical practice is challenged by the premise related to treatment adherence (Yuan et al., 2018). In other words, patience are likely to forget self-help interventions administered through bibliotherapy considering that individuals rely on written materials and other electronic media to practice behavior change. This can lead to a delay in help-seeking behavior of patients.

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Assignment: Keeper Study ESSAY

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