Running head: research Article

Research Article Critique

Lycia L. Harris
Jacksonville State University

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In this article, the title and abstract gives the reader a good idea what the paper is about.
The abstract, serves as a brief guide to direct the reader through the paper. Research methods are
the techniques researchers use to structure a study and to gather and analyze information relevant
to the research question (Polit & Beck, 2017). This type of research is a quantitative study.
Quantitative data analyzes data through statistical analyses both simple and complex (Polit &
Beck, 2017).
In this article, the experiences of nurses participating in exercise activities are evaluated
as they relate to the health promotion activities they encourage in their patients when doing
discharge teaching, which is both interesting and eye opening. The title of the article is
Registered nurses beliefs of the benefits of exercise, their exercise behavior and their patient
teaching regarding exercise. It was written in 2011 and published in the International Journal of
Nursing Practice. According to the article, the purpose of this particular study was to look at the
relationships of nurses beliefs on the benefits of exercise, the actual exercise behaviors of the
nurses, and what the nurses would recommend to their patients regarding exercise based on the
nurses own experiences (Esposito & Fitzpatrick, 2011). The lead author, Eileen M Esposito,
DNP, MPA, RN-BC, is the Assistant Executive Director of Ambulatory Patient Care Services and
Quality for the North Shore-Long Island Jewish Health System in New York (prolibraries.com).
She is responsible for the management and coordination of performance improvement
activities and community services for the Faculty Practice and hospital clinics across multiple
sites and has presented topics of Ambulatory interest in various settings including the Joint
Commission Satellite Network and the American Academy of Ambulatory Nurses
(prolibries.com). Dr. Esposito has published several articles in national journals on performance
improvement and is a contributing author to the American Academy of Ambulatory Care Nurses

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core curriculum (prolibraries.com). Co-author, Joyce J. Fitzpatrick, PhD, MBA, RN, FAAN, is
the Elizabeth Brooks Ford Professor of Nursing at Frances Payne Bolton School of Nursing at
Case Western Reserve University (CWRU) in Cleveland, Ohio (anfonline.org). She was elected
a Fellow in the American Academy of Nursing in 1981, 1996 a Fellow in the National
Academies of Practice, received the American Journal of Nursing Book of the Year Award 18
times, the Midwest Nursing Research Society Distinguished Contribution to Nursing Research
Award and several other distinguished recognitions in nursing excellence (anfonline.org). Dr.
Fitzpatrick is well published in health care literature and has over 300 publications
(andonline.org). Both authors have extensive research experience and are considered experts.
Several research questions were addressed:
1. What is the relationship between the nurses beliefs of the benefits of exercise and
their reported exercise behavior?
2. What is the relationship between nurses beliefs of the benefits of exercise and their
recommendation of regular exercise to patients?
3. What is the relationship between the nurses exercise behavior and their
recommendations of regular exercise to patients?
The researchers gave good evidence to answer the posed questions and the data gave
merit to the necessity of the study. There was a huge relationship between the nurses exercise
participation and predictable variables. Those variables were: perceived self-efficacy, perceived
benefits of and perceived barriers to exercise (Esposito & Fitzpatrick, 2011). Researchers also
discovered that nurses who exercised and practiced healthy activities were more likely to council
their patients to do the same. The nurses who found that their patients were non-compliant to
their recommendations were most often influenced by family members who did not participate in
healthy activities.

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The study was conducted in 2011 and the literature search consisted of 29 sources. The
sources were current for the time and represented several disciplines such as sports medicine,
cardiovascular and womens health, health promotional practices and the data represented
different age groups. The number of studies in the literature, however, that examined the
perceived benefits of exercise and reported physical activity of the studied nurses was limited
(Esposito & Fitzpatrick, 2011). In the research that involved foreign countries, the nurses
perceptions and experiences related to health care were looked at verses the research that was
done in the United States that studied exercise beliefs and barriers of lay people and university
students (Esposito & Fitzpatrick, 2011). The studies that looked at the relationships between
healthy behaviors/exercise and health promotion counseling were limited for nurses and thus,
nutritionist, doctors, midwives, and physical therapist were used instead (Esposito & Fitzpatrick,
2011).
The actual information in the study is not consistent and the main focus group. Nurses
were also not always available for the study. The conclusion of the study seemed to have been
reached based on inconsistent data. This study was based on Penders Theory of Health
Promotion. Penders model defines health as a positive dynamic state and is not just simply the
absence of disease (nursing-theory.org).
This model focuses on individual characteristics, experiences, behavior-specific cognition
and affect, behavioral outcomes, and notes that each person has unique personal characteristics
and experiences that affect their actions (nursing-theory.org). Based on Penders Theory, the
variables are linked logically and the theory guides the questions and variable relationships.
Individuals who believe in and understand the benefits of exercise for health promotion and
wellness will participate health promotion activities. Health promotion is the ultimate goal of

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nursing interventions both inside and outside of healthcare settings (Esposito & Fitzpatrick,
2011). The design of the study was based on a correlational descriptive study of three key
variables: beliefs regarding the benefits of exercise, reported exercise behaviors, and
recommendation of exercise to participants for health promotion as part of a treatment plan
(Esposito & Fitzpatrick, 2011).
The study was conducted in a large metropolitan hospital. All registered nurses who
provided direct patient care to non-critical adults in a medical/surgical atmosphere were
recruited. The research question matched the method as it was a correlational descriptive study.
The research questions sought to relate behaviors with actions. Nurses were recruited by word of
mouth, email and posters and both full and part-time employees were allowed to participate.
The sampling was not appropriate for the setting. A convenience sample of 112
nurses completed the questionnaire. A convenience sample does not represent the true
population; it only represents the people who were available at the time of the study. This nurse
feels that the study group was not represented appropriately. The tools validity was discussed
and it was determined that the recommendations of exercise for health promotion scores were not
checked for reliability and were identified as single-item instruments (Esposito & Fitzpatrick,
2011).
The results indicated that the average age of the responding nurses was 43 years old and
most were female. The largest respondents worked day shift and over half had bachelors
degrees. There were however, some males that participated in the study, and their mean body
mass index was 31.78 which indicated that they were all overweight or obese. Of the 96 female
nurses, the mean BMI was 25.76 which translated into two being underweight; 43 being of
normal weight; 25 were overweight and 14 were obese (Esposito & Fitzpatrick, 2011). Based on

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the data, the results were as expected: a positive correlation was identified between nurses who
exercised and those who taught exercise and health promotion as part of their discharge plans.
The information found in this study was linked to the previous study. The BMI results in
the present studies were lower than those found in the six-state nurses study (Esposito &
Fitzpatrick, 2011). Review of the statistics for the USA showed 66.3% of the population are
overweight or obese and the New York state sample statistics show 25.2% of all adults over 20
years of age are obese (Esposito & Fitzpatrick, 2011). Neither the Type I or Type II errors are
discussed. According to the conclusion, the information in the study would need to be reevaluated in a different setting and regions of the country before results could be generalized and
this nurse agrees (Esposito & Fitzpatrick, 2011).
The authors suggest that this study offers new information on ways that nurses can
educate their patients on the benefits of exercise and this nurse also agrees with that information.
Nurses who engage in positive health behaviors and regular exercise can have a positive
influence on the lives and health of their patients and patients families.

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References
Eileen M. Esposito, RN-BC, DNP, MPA, CPHQ. (2016, Retrieved: June 11). Retrieved from
American Academy of Ambulatory Care Nursing: Speaker's Profile:
http://www.prolibraries.com/aaacn/?select=speaker&speakerID=5172
Esposito, E. M. (2011). Registered nurses' beliefs of the benefits of exercise, their exercise
behaviour and their patient teaching regarding exercise. International Journal of Nursing
Practice (17), 351-356.
Health Promotion Model. (2016, Retrieved: June 10). Retrieved from Nursing Theory:
http://www.nursing-theory.org
Joyce J. Fitzpatrick. (2016, Retrieved: June 10). Retrieved from American Nurses Foundation:
http:www.anfonline.org/Main/AboutANF/Boardoftrustees/Joyce-Fitzpatrick.html
Polit, D. F. (2017). Nursing Research: Generating and Assessing Evidence for Nursing
Practice. (10th Ed.). Printed in China: Wolters Kluwer.
Tompkins, T. B. (2009). Nurse practitioner practice patterns for exercise counseling. Journal of
The American Academy of Nurse Practitioners, 21(2), 79-86. doi: 10.1111/j.17457599.2008.00388.x.

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Yuan S., C. M. (2009). An intervention program to promote health-related physical fitness in

nurses. Journal of Clinical Nursing (18) 10, 1404-1411. doi:10.1111/j.13652702.2008.02699.x.