Evidence-based practice is a requirement of the Nursing and Midwifery Council (NMC) (2018) Code, so incorporating these activities into practice is vital for nurses. This essay critiques a research study carried out by Sawer et al. (2020) with the title, Is shame a barrier to sobriety? A narrative analysis of those in recovery. Subsequent to critiquing the research, two of the findings will be analysed critically to consider these in the light of the broader evidence base. Finally, the discussion will evaluate how evidence-based research can enhance or affect practice before arriving at conclusions on this topic. The study of Sawer et al. (2020) was critiqued utilising a critical review form for qualitative studies developed by Letts et al. (2007). The findings for each of the sections of this form can be seen in the Appendix. It should be noted at the outset that the type of research undertaken was in this case, qualitative. According to Grove and Gray (2022, p. 21) “Qualitative research is a systematic subjective approach used to describe life experiences and situations and give them meaning.” This helps to understand the perspectives, perceptions and worldviews of participants (De Chesnay, 2016). It differs very significantly from quantitative research paradigms which are typically based on gathering numbers and testing theory. Given that the authors wished to understand experiences in depth, the approach of Sawer et al. (2020) may be considered suitable for this study. The research design itself was a narrative inquiry – also suitable because this seeks to understand participants’ own stories in their own words  and comprehending lived experience (Blessinger and Carfora, 2015). Sawer et al. (2020, p. 79) clearly articulate their research questions which were: “In what ways do participants tell their stories of shame? And how is shame experienced and/or understood by those in recovery from alcohol dependence?” This helps demonstrate study reliability as the research questions are suited to the research design and type of research. Sawer et al. (2020) gathered their sample of participants from Alcoholics Anonymous, including five males and three females within the study, and using a snowball sampling-based approach. Sampling is the process of selecting participants from the total population to take part in the study, aiming to include representative individuals from the wider group (Cernat et al, 2022). Snowball sampling is a technique that is usually used to access difficult to access populations, through asking participants for referrals to other potential participants (Terry, 2017). While it is very useful for this purpose, it also has the risk of sampling bias creeping into the process because people may potentially refer others that have similar experiences or worldviews, meaning that the research may narrow in its findings (Fain, 2017). This ultimately can lead to issues of reliability, trustworthiness and validity in research. Typically, in quantitative research, researchers seek to achieve saturation of data (Boswell and Cannon, 2022) which occurs when researchers are gathering data, and no new information is being found. Another key problem with the study of Sawer et al. (2020) is that the researchers do not refer to this within their study. This leads to further questions about reliability and trustworthiness of the findings, and the extent of academic rigour applied overall. On data collection, the authors used interviews with a view to encourage the telling of stories in some detail, with one initial question used asking about the participant’s story of recovery, followed up by further prompts to gain more data from participants (Sawer et al., 2020). Though the authors did not use the word “shame” in the interview, they did in the participant information sheet (Sawer et al., 2020). The use of semi structured interviews in this way is well-aligned to a qualitative research approach (Holloway and Galvin, 2016). It is not clear from the research why other techniques such as focus groups were not considered, since these can gather a greater depth of information when used at the right times (Dingwall and Staniland, 2020), however, this may be due to the nature of the topic and a possible reluctance to discuss shame in front of others. From the perspective of academic robustness, discussion of why not focus groups could have been helpful. On data analysis, Sawer et al. (2020, p. 80) carefully detail out their five step approach adopted from Crossley, which included reading and familiarising, identifying narrative tone, identifying imagery and themes, weaving a coherent story and cross analysis to synthesise themes. From a trustworthiness and validity perspective, noticeably missing from the Sawer et al. (2020) study is any reference as to how their own worldviews and beliefs may have shaped the data collected, its analysis and findings, since as Dewing et al. (2021) point out, this could have a significant influence. Holloway and Galvin (2016) argue that it could also draw in the potential for bias, leading to validity and reliability concerns. Finally, the study was conducted according to ethical principles, and this is seen throughout the documentation of the research of Sawer et al. (2020). Sawer et al. (2020) describe how they sought ethical approval at the outset, and the use of informed consent forms to help ensure that harm did not come to participants (Llahana et al., 2019). They also anonymised names to ensure that participants could not be identified (Williamson and Whittaker, 2019) which might be considered particularly important on the topic of shame relating to alcohol misuse. One possible area for improvement might have been to signpost participants to extra counselling services, or having a counsellor present, since it is possible to imagine that the content may have been distressing for some, potentially. One of the main findings of the Sawer et al. (2020) research was that participants had a deep seated negative view of self, present well before they were dependent on alcohol. Critiquing this finding, a few other studies were identified on undertaking a search, which support this point. In particular, the study of Kougiali et al. (2021) on mechanisms and processes involved in women’s pathways into alcohol dependence and towards recovery also highlights this point. The research of Kougiali et al. (2021) was a qualitative meta-synthesis of other studies undertaken in this field, identifying 23 research papers of relevance. Kougiali et al. (2021, p. 437) showed that there was a link between difficult situations in childhood and how this impacted on the person’s sense of self. Shame and stigma was seen to be present long before alcohol dependence, and sometimes it was found to delay seeking recovery, however, once recovery began, the authors showed that this helped revise the concept of self (Kougiali et al., 2021). This mirrors the findings of Sawer et al. (2020, p. 83) which showed that participants felt they had faults and that they had a “fault with self” which alcohol could relieve. Sawer et al. (2020) also pinpointed the concept that shame was likely to delay going to start the recovery process. Furthermore, while on the subject of offending and prison rather than alcohol dependence, Flood (2018) found that being able to recover and transform self-required shedding underlying feelings of shame. While the subject is somewhat different, the same overall process of deep seated shame can be seen to impact on change for a person (Flood, 2018) further adding some weight to the findings of Sawer et al. (2020). Importantly, the research of Kougiali et al. (2021) might be considered higher up on the hierarchy of evidence than the research of Sawer et al. (2020). This is because the work of Kougiali et al. (2021) can be seen to be a robust and comprehensive review of other qualitative studies already existing in this specific area of research (Greenhalgh, 2019). Meanwhile, the study of Sawer et al. (2020) is lower down on the hierarchy of evidence because it represents just one small scale study into this topic. While there are various different hierarchies of evidence that have been proposed, as can be seen from the analysis of Melnyk and Fineout-Overholt (2018) in all cases, meta synthesis of qualitative studies are always considered more academically robust than a single qualitative study. Of course, this does depend on how the meta synthesis was conducted, since if the methodology was not academically robust this might affect validity of the Kougiali et al. (2021) findings, a point which does also challenge the hierarchy of evidence as a concept overall (Houser et al., 2016). Nonetheless, the study of Kougiali et al. (2021) does appear to be reliable, trustworthy and valid, so this is not the case in this scenario. A second key finding of the Sawer et al. (2020) study was that participants’ recovery was enabled through being able to discuss and make sense of personal shame arising from experiences. On searching the literature, no one study was identified that outlined this exact finding, though there were some similar and related findings within the literature base. For example, research undertaken by Romo and Obiol (2021) that carried out interviews of 22 adults in alcohol recovery found that the way in which participants handled stigma and associated shame influenced their recovery. This lead Romo and Obiol (2021) to outline the importance of Alcoholics Anonymous and other treatment centres to use communication to break down stigma to lower barriers to recovery. Moreover, other research undertaken showed that one key stage in recovery was discussing shame with others and developing accountability which helped as a commitment to overcome drinking (Chambers et al., 2017). However, the Chambers et al. (2017) study was based on the use of an online help group/network rather than in-person AA-style recovery, which means that the findings could diverge from those of Sawer et al. (2020) as a result of this. This is particularly pertinent given the point of Chambers et al. (2017) that online networks give people control over how they choose to present themselves – which may not necessarily align with the reality.