Plus-Hex CLINICAL
All reported studies published in journals should acknowledge the ethical issues related to , among others , consent to the study . The reader of the paper should be able to ascertain that ethical approval has been gained by the researcher ( s ) [ 36 ] . The study of Doherty et al . [ 45 ] was approved by the East Midlands Nottingham Research Ethics Committee . Randall et al . [ 46 ] did not need ethical approval as it was a systematic analysis , but they did state that 19 papers were removed due to a lack of discussion relating to methodology , recruitment processes , or ethical considerations and approval . Finally , Qvist et al . [ 47 ] was approved by The Danish Data Protection Agency and by the Danish Health and Medicines Authority . Although Doherty et al . [ 45 ] and Qvist et al . [ 47 ] were approved , they do not go into any more detail about the ethics of the study .
Validity is defined as the extent to which a concept is accurately measured in a quantitative study , and reliability relates to the consistency of a measure [ 49 ] . Out of Doherty et al . [ 45 ] , Randall et al . [ 46 ] and Qvist et al . [ 47 ] , it is Qvist et al . [ 47 ] that is the most valid and reliable . This is because it is comparing a real-world population and a clinical trial population .
Published papers should always include a conclusion that briefly sums up the findings of the author ( s ) and the implications , if any , for practice [ 36 ] . Doherty et al . [ 45 ] has no conclusion , so the author could not analyse it . Qvist et al . [ 47 ] incorporated a conclusion but it is not signposted by a heading . This makes it difficult for the reader to ascertain where the conclusion is , in order to critically appraise it . If the conclusion cannot be easily found , questions cannot be answered , such as : Did the study achieve its aim ? If relevant , is the hypothesis accepted or rejected ? Are the conclusions based on , and supported by , the results ? What recommendations are made for practice ? Are these recommendations relevant , specific and feasible ? [ 36 ]
Results
The studies showed that HRQOL is reduced in overweight and obese dogs but improves after successful weight loss [ 6 ] . For managing weight loss in overweight dogs , dietary calorific restriction is more effective than increasing physical activity [ 7 ] . Finally , nurse-led clinics in areas of human medicine such as atrial fibrillation and gout have proved efficacious , and this could be transferred to the veterinary field .
Discussion
Strengths and limitations of the study
This review examined seven pieces of primary research that were all published in peer-reviewed journals . Peer review ensures the papers are legitimate and reliable [ 50 ] . However , all studies had to fit a specific criterion , meaning the inclusion of more studies would be difficult .
Limitations of this review include the fact that only seven studies were incorporated . Had more studies been incorporated , the transferability of this literature review to VN-led clinics for canine weight management would have increased . Another limitation of the review is the fact that , as the author was a novice researcher , the identification , critique and bringing together of the literature may not have been as thorough as that of a more experienced researcher [ 43 ] .
The author was also faced with time and resource limitations , and they were able to incorporate only up to eight studies in this review . They did not have the finances to retrieve more literature via interlibrary loans or to visit libraries further afield . Additional funding may also have enabled the author to employ the assistance of other researchers , who would have aided them in the search , critique and bringing together of the literature .
The author has learned that they should keep better notes of their techniques when searching for literature . In future , the author would approach a literature review in a similar way , but would have the skills and techniques to streamline their content and make it more succinct . The author was not surprised by the final outcomes of the review as they were in line with expectations .
Discussion of the findings
Canine obesity is important when considering animal welfare and the role of the VN , allowing effective advice to be provided . All the research reviewed had limitations , but canine obesity will be considered , leading to a discussion about how VNs can implement VN-led clinics in practice . Throughout the primary research , three key themes have arisen : weight loss , HRQOL and the efficacy of nurse-led clinics in human medicine .
The VN can implement VN-led clinics in order to prevent and reduce canine obesity . Dietary calorific restriction can be included in these VN-led clinics . This was supported by Chapman et al . [ 7 ] , who found that dietary calorific restriction is more effective for weight loss in overweight dogs compared with increased activity . Thirteen dogs participated in the trial , with six dogs assigned to the dietary calorific restriction group and seven dogs assigned to the physical activity intervention .
All dogs in the dietary calorific restriction group lost weight , with the median percentage weight loss being consistent with rates of weight loss seen in previous studies . In contrast , although six of the seven dogs in the physical activity group did lose some weight , the amount lost was relatively modest ( up to 6 %) and not statistically significant . This shows a significant difference between calorific restriction and increased physical activity . This can be implemented in practice by the VN suggesting calorific restrictions in VN-led clinics .
Volume 38 ( 3 ) • June 2023
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