Critiquing Evaluation Criteria for Quantitative Research Article Listed below are criteria that you will use to critique research articles pertinent to your research area of interest. Discuss how the investigator satisfied each criterion. Cite relevant passages in the articles, with reference to page number if appropriate. Don’t merely respond “yes” or “no” to the presence or absence of each criterion – you must provide examples and rationale for your response. Criteria YES NO Comments I- Title of the Article and Authors Is the title clear, including area of study and group studied? Are the author’s credentials included? II- Introduction Is the purpose of the study presented? Is the significance (importance) of the problem discussed? Does the investigator provide a sense of what he or she is doing and why? III- Problems Statement Is the problem statement clear? Does the investigator identify key research questions and variables to be examined? Does the study have the potential to help solve a problem that is currently faced in clinical practice? IV- Literature Review Does the literature review follow a logical sequence leading to a critical review of supporting and conflicting prior work? Is the relationship of the study to previous research clear? Does the study have the potential gaps in the literature and support the necessity of the present study? V- Theoretical Framework and Hypotheses Is a rationale stated for the theoretical/conceptual framework? Does the investigator clearly state the theoretical basis for hypotheses formulation? Is the hypotheses stated precisely and in a form that permits it to be rested? VI- Methodology Are the relevant variables and concepts clearly and operationally defined? Is the design appropriate for the research questions or hypotheses? Criteria YES NO Comments Are methods of data collection sufficiently described? What are the identified and potential threats to internal and external validity that were present in the study? If there was more than one data collector, was interrater reliability adequate? VII- Sample Are the subjects and sampling methods described? Is the sample of sufficient size for the study, given the number of variables and design? Is the adequate assurance that the rights of human subjects were protected? VIII- Instruments Are appropriate instruments for data collection used? Are reliability and validity of the measurement instruments adequate? IX- Data Analysis Are the statistical tests used identified and the values reported? Are appropriate statistics used, according to level of measurement, sample size, sampling method, and hypotheses/research questions? X- Results Are the results for each hypothesis clearly and objectively presented? Do the figures and tables illuminate the presentation of results? Are results described in light of the theoretical framework and supporting literature? XI- Conclusion/Discussion Are conclusions based ...

1. Critiquing Evaluation Criteria for Quantitative Research Article
Listed below are criteria that you will use to critique research
articles pertinent to your research
area of interest. Discuss how the investigator satisfied each
criterion. Cite relevant passages in the
articles, with reference to page number if appropriate. Don’t
merely respond “yes” or “no” to the
presence or absence of each criterion – you must provide
examples and rationale for your response.
Criteria YES NO Comments
I- Title of the Article and Authors
Is the title clear, including area of study and group studied?
Are the author’s credentials included?
II- Introduction
Is the purpose of the study presented?
Is the significance (importance) of the problem discussed?
Does the investigator provide a sense of what he or she is doing
and why?
III- Problems Statement
Is the problem statement clear?
Does the investigator identify key research questions
and variables to be examined?

2. Does the study have the potential to help solve a problem that
is currently faced in clinical practice?
IV- Literature Review
Does the literature review follow a logical sequence leading to
a critical review of supporting and conflicting prior work?
Is the relationship of the study to previous research clear?
Does the study have the potential gaps in the literature
and support the necessity of the present study?
V- Theoretical Framework and Hypotheses
Is a rationale stated for the theoretical/conceptual framework?
Does the investigator clearly state the theoretical basis for
hypotheses formulation?
Is the hypotheses stated precisely and in a form that permits it
to
be rested?
VI- Methodology
Are the relevant variables and concepts clearly and
operationally
defined?
Is the design appropriate for the research questions
or hypotheses?
Criteria YES NO Comments

3. Are methods of data collection sufficiently described?
What are the identified and potential threats to internal
and external validity that were present in the study?
If there was more than one data collector, was interrater
reliability adequate?
VII- Sample
Are the subjects and sampling methods described?
Is the sample of sufficient size for the study, given the number
of variables and design?
Is the adequate assurance that the rights of human subjects were
protected?
VIII- Instruments
Are appropriate instruments for data collection used?
Are reliability and validity of the measurement
instruments adequate?
IX- Data Analysis
Are the statistical tests used identified and the values reported?
Are appropriate statistics used, according to level of
measurement, sample size, sampling method, and
hypotheses/research questions?
X- Results
Are the results for each hypothesis clearly and
objectively presented?
Do the figures and tables illuminate the presentation of results?

4. Are results described in light of the theoretical framework and
supporting literature?
XI- Conclusion/Discussion
Are conclusions based on the results and related to
the hypotheses?
Are study limitations identified?
Are implications of findings discussed (i.e., for
practice, education, and research)?
Are recommendations for further research stated?
XII- Research Utilization Implications
Is the study of sufficient quality to meet the criterion of
scientific
merit?
Does the study meet the criterion of replicability?
Is the study of relevance to practice?
Do the benefits of the study outweigh the risks?
XIII- Format
Utilizes APA format
Includes the list of references utilizing APA

5. Depression among patients with end-stage renal disease in
hemodialysis
Geraldo B. Silva Juniora,b,c*, Elizabeth F. Daherb, Ana Paula
A. Buosid,
Rafael S.A. Limac, Mikaelly M. Limac, Eveline C. Silvac, Aline
M. Sampaiob,
João Moisés L. Santanac, Francisco Emmanuel C. Monteiroc
and Sônia M.H.A. Araújoa
aSchool of Medicine, University of Fortaleza, Fortaleza, Brazil;
bDepartment of Internal
Medicine, School of Medicine, Federal University of Ceará,
Fortaleza, Brazil; cCentro de
Nefrologia de Caucaia, Caucaia, Brazil; dSchool of Psychology,
State University of Ceara,
Fortaleza, Brazil
(Received 28 May 2013; accepted 12 September 2013)
Depression is frequent in end-stage renal disease (ESRD) and
predicts mortality in
dialysis patients. The aim of this study was to investigate the
occurrence of
depression among patients on hemodialysis. We conducted an
observational cross-
sectional study at two hemodialysis centres in the metropolitan
area of Fortaleza,
Ceará, Brazil, between September and October 2010. The
occurrence of depression
was evaluated according to Beck Depression Inventory II.
Among 148 patients
interviewed, the mean age was 46 ± 13 years and 54% were
male. The average

6. time on dialysis was 5.3 ± 5.2 years. Depression was found in
101 (68.2%) cases.
Depression was classified as mild (49.5%), moderate (41.5%)
and severe (9%). Only
15.5% had prior depression diagnosis. Follow-up with
Psychologist was being done
in only 32.4% of cases. Patients with depression had a higher
frequency of
antidepressant use (20.7% vs. 4.2%, p = .01) and
benzodiazepines (33.6% vs. 8.5%,
p = .001). Among patients using antidepressant, improvement of
symptoms was
reported by 81.6%. Depression is one potentially modifiable
risk factor in ESRD.
The investigation and multidisciplinary approach of depression
should be part of
routine evaluation of patients on dialysis.
Keywords: depression; chronic kidney disease; end-stage renal
disease; hemodialysis
Introduction
Chronic kidney disease (CKD) and its treatment represent a
major stress for the affected
individuals and, frequently, require considerable social
adaptation. There are many
factors reported to be associated with health-related quality of
life including age, gender,
education, income, comorbid conditions, hemoglobin level,
personality characteristics,
depression, anxiety and others (Franke, Reimer, Philipp, &
Heemann, 2003; Matas
et al., 2002; Prihodova et al., 2009).
The prevalence of depression is higher in end-stage renal

7. disease (ESRD) patients
than in the general populations (Chilcot, Wellsted, Da Silva-
Gane, & Farrington, 2008)
and predicts mortality in dialysis patients (Riezebos, Nauta,
Honig, Dekker, & Siegert,
2010). The aim of this study is to investigate the occurrence of
depression among
patients with CKD on hemodialysis.
*Corresponding author. Email: [email protected]
© 2013 Taylor & Francis
Psychology, Health & Medicine, 2014
Vol. 19, No. 5, 547–551,
http://dx.doi.org/10.1080/13548506.2013.845303
mailto:[email protected]
http://dx.doi.org/10.1080/13548506.2013.845303
Methods
This was an observational cross-sectional study conducted at
two hemodialysis centres in
the metropolitan area of Fortaleza, Ceará, Brazil, between
September and October 2010.
The Beck Depression Inventory II (BDI-II) questionnaire
consisting of 21 items was
administered as a diagnostic tool (Beck, Ward, Mendelson,
Mock, & Erbaugh, 1961). A
signed consent was obtained before filling out the forms.
Depression was classified as
mild (score 10–18), moderate (score 19–29) and severe (score
>30). The study protocol
was reviewed and approved by the Ethics Committee of the
University of Fortaleza.

8. Statistical analysis was performed using Epi Info, version
6.04b. The comparison
between two groups of patients (depression vs. non-depression)
was done using Student’s
t-test, Fischer exact test, Mann–Whitney test and Chi-square
test when appropriate.
“p values” below 5% ( p < .05) were considered statistically
significant.
Results
A total of 180 patients were interviewed, of which 148 accepted
in answer the question-
naire. The mean age was 46 ± 13 years and 54% were male. The
average time on dialy-
sis was 5.3 ± 5.2 years. Depression was found in 101 (68.2%)
cases. The intensity of
depression was classified as mild in 50 (49.5%), moderate in 42
(41.5%) and severe in
9 (9%) patients. Only 23 patients (15.5%) had prior depressive
diagnosis. Follow-up
with Psychologist was being done in only 48 cases (32.4%).
Comparison between
patients with and without depression showed similar age (45.2 ±
14 years vs.
48.2 ± 12.9 years, p = .21), gender (male 53.4% vs. female
55.3%, p = .86) and time on
dialysis (5.5 ± 5.2 vs. 4.9 ± 5.1 years, p = .51) (Table 1).
Patients with depression had a
higher frequency of antidepressant use (20.7% vs. 4.2%, p =
.01) and benzodiazepi nes
(33.6% vs. 8.5%, p = .001). Among 46 (86.9%) patients who
were using antidepressant,
improvement of symptoms was reported by 40 (81.6%) patients.
A comparison between

9. Table 1. Comparison of depression and non-depression in
patients with ESRD in hemodialysis.
Parameter Depression (n = 101) Non-depression (n = 47) p
Age (years) 45.2 ± 14.0 48.2 ± 12.9 .21
Gender
Male 54 (53.4%) 26 (55.3%) .86
Female 47 (46.6%) 21 (44.7%) .10
Employment 33 (32.6%) 22 (46.8%) .10
Time on dialysis (years) 5.5 ± 5.2 4.9 ± 5.1 .51
Previous kidney transplantation 7 (6.9%) 6 (12.7%) .34
Preparing to kidney transplantation 40 (39.6%) 23 (48.9%) .29
BDI-II score 19.4 ± 7.8 5.5 ± 2.6 .0001
Use of antidepressant 21 (20.7%) 2 (4.2%) .01
Use of benzodiazepines 34 (33.6%) 4 (8.5%) .001
Improvement with medication 40 (39.6%) 6 (12.7%) .001
Psychologist follow-up 36 (35.6%) 12 (25.5%) .26
Family history of depression 28 (27.7%) 10 (21.2%) .54
Low income 79 (78.2%) 41 (87.2%) .26
Family support 76 (75.2%) 41 (87.2%) .12
Smoking 8 (7.9%) 2 (4.2%) .50
Alcoholism 7 (6.9%) 4 (8.5%) .74
Physical activity 27 (26.7%) 15 (31.9%) .55
Notes: BDI-II = Beck Depression Inventory II. Values
expressed as mean ± SD. Student’s t-test and Fisher
exact test. Significant p < .05.
548 G.B. Silva Junior et al.
patients with moderate to severe depression and patients
without depression is shown in

10. Table 2.
Discussion
Depression is widely recognized as the most common
psychiatric problem in patients
with ESRD and is considered the second most common medical
problem in this popula-
tion after hypertension (Chilcot et al., 2008). Depression has
been associated with lack
of adherence to treatment, suicidal tendencies and poor survival
rates (Diefenthaeler,
Wagner, Poli-de-Figueiredo, Zimmermann, & Saitovitch, 2008).
It is important to
consider that complaints of malaise, anorexia and sleep
disturbances can be mistaken
for depressive symptoms (Murtagh, Addington-Hall, &
Higginson, 2007). Chilcot,
Davenport, Wellsted, Firth, and Farrington (2011) found
significant depressive
symptoms (BDI-II score ≥ 16) in 25% of hemodialysis patients.
In the present study,
depression was found in 68% of cases, which is impressive
high.
Most studies performed worldwide report increased depressive
symptoms in females
(Araújo et al., 2012; Saeed, Ahmad, Shakoor, Ghafoor, &
Kanwal, 2012). In the present
study, the majority of depressed patients (54%) were male.
According to another study
(Chilcot et al., 2011), only 15% of depressed patients had prior
depressive diagnosis.
Despite the high incidence of depression in dialysis patients, the
diagnosis is often

11. missed and not addressed, focusing only on the physical aspects
of the disease (Cukor,
Cohen, Peterson, & Kimmel, 2007). Saeed et al. (2012) found
moderate and severe
depression in 75% of studied cases. In the present study, only
15% had prior depressive
diagnosis. The intensity of depression was classified as mild in
50%, moderate in 41%
and severe in 9% of patients.
Employment status of an individual was associated with higher
frequency of depres-
sion (Saeed et al., 2012). In our patients with depression, 67%
were unemployed and
78% had low income level, but there were no statistical
difference between depressive
Table 2. Comparison of moderate-severe depression and non
depression in patients with ESRD
in hemodialysis.
Moderate-severe
depression (n = 55)
Non-depression
(n = 47) p
Age (years) 45.5 ± 14.1 48.2 ± 12.9 .26
Gender
Male 29 (52.7%) 26 (55.3%) .83
Female 26 (47.3%) 21 (44.7%)
Employment 33 (60%) 22 (46.8%) .52
BDI-II score 22 ± 6.8 5.5 ± 2.6 .0001
Time on dialysis (years) 6.2 ± 6.0 4.9 ± 5.1 .40
Previous transplantation 5 (9.0%) 6 (12.7%) 1.0
In preparation for transplantation 22 (40%) 23 (48.9%) .40

12. Family support 42 (76.3%) 41 (87.2%) .19
Use of medication 28 (51%) 6 (12.7%) .0001
Use of antidepressant 11 (20%) 2 (4.2%) .06
Use of benzodiazepine 21 (38%) 4 (8.5%) .0001
Psychologic follow-up 23 (41.8%) 12 (25.5%) .28
Improvement with medication 22 (78.5%) 6 (12.7%) .005
Notes: Values expressed as mean ± SD. Student’ s t-test and
Fisher exact test. Significant p < .05.
Psychology, Health & Medicine 549
and non-depressive group, maybe due to the high prevalence of
unemployment and low
income.
There is mixed evidence that treating depression has a positive
impact on survival
outcomes in other physical illnesses (Detweiler-Bedell,
Friedman, Leventhal, Miller, &
Leventhal, 2008). The use of antidepressants is reported to be as
low as 10% (Chilcot
et al., 2011). In the present study, only 20% of patients with
depression were using
antidepressant and 33% benzodiazepines. Among patients using
antidepressant, 82%
reported improvement of symptoms.
In summary, depression is one potentially modifiable risk factor
that is associated
with high mortality and non-adherence among patients in
dialysis. Depression is a
frequent and underdiagnosed disease in these patients. Follow -
up with a Psychologist is

13. also uncommon, as well as the specific drug treatment. The
investigation of depression
should be part of routine monitoring of patients on dialysis.
Multidisciplinary approach
needs to be sought in treating dialysis patients involving
Psychologists, Psychiatrists
and Nephrologists to improve the quality of life in these
patients.
Study limitations
There are some limitations in this study. The number of patients
could be higher, but it
is difficult to convince all patients of our centre to enrol the
study. The cut-off values
used in the questionnaire may overestimate the prevalence of
depression. There are also
other approach methods to assess depression in these patients.
References
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Medeiros, C.A., & de Bruin, P.F.
(2012). Risk factors for depressive symptoms in a large
population on chronic hemodialysis.
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K. (2011). An association between
depressive symptoms and survival in incident dialysis patients.
Nephrology Dialysis Trans-
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14. Chilcot, J., Wellsted, D., Da Silva-Gane, M., & Farrington, K.
(2008). Depression on dialysis.
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Psychology, Health & Medicine 551
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16. Abstract Introduction Methods Results Discussion Study
limitationsReferences