PICOT Question And Literature Search

PICOT Question And Literature Search

PICOT Question And Literature Search

Summary of Clinical Issue: As part of their professional mandate, nurses should be identifying problems facing the populace and develop appropriate interventions. Like other professions, however, challenges are part of everyday practice. One of the widespread problems is a scenario where a proportion of the population is at risk of an illness. When a group is vulnerable, it implies that the entire public health is at risk, and such a group’s productivity declines. In such situations, nurses and other health care providers should be more committed to designing the most practical and safest interventions to ensure that the problem does not lead to severe outcomes such as death.

In this analysis, the clinical problem of interest is type 2 diabetes among older adults. According to Yakaryılmaz and Öztürk (2017), the prevalence of type 2 diabetes is expected to increase proportionately as the population’s age and life expectancy prolong. This point implies that older people will be at risk of the illness and its secondary complications such as depression and cognitive impairment. It predicts a situation where health care providers will be burdened if the right approaches are not used to help decrease the rate of type 2 diabetes in older adults. The intervention of interest is avoiding pharmacological management of the disease and opting for lifestyle changes.

PICOT Question: In older adults with type 2 diabetes (P), can lifestyle changes (I) compared to medical interventions (C) help to reduce the rate of infection (O) in six months (T)?

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Criteria Article 1 Article 2 Article 3
APA-Formatted Article Citation with Permalink Jackson, S. L., Long, Q., Rhee, M. K., Olson, D. E., Tomolo, A. M., Cunningham, S. A., Ramakrishnan, U., Narayan, K. M., & Phillips, L. S. (2015). Weight loss and incidence of diabetes with the Veterans Health Administration MOVE! lifestyle change programme: an observational study. The lancet. Diabetes & endocrinology3(3), 173–180. https://doi.org/10.1016/S2213-8587(14)70267-0

 

Reeve, E., Low, L. F., & Hilmer, S. N. (2016). Beliefs and attitudes of older adults and carers about deprescribing of medications: a qualitative focus group study. Br J Gen Pract66(649), e552-e560.doi: https://doi.org/10.3399/bjgp16X685669

 

Fowler, S. P., Williams, K., & Hazuda, H. P. (2015). Diet soda intake is associated with long‐term increases in waist circumference in a biethnic cohort of older adults: the San Antonio Longitudinal Study of Aging. Journal of the American Geriatrics Society63(4), 708-715. https://doi.org/10.1111/jgs.13376
How Does the Article Relate to the PICOT Question? It is centered on the premise that participating in lifestyle change programs can reduce the incidence of type 2 diabetes in clinical settings and communities. It follows the premise that medication procedures are not as effective as lifestyle programs in managing type 2 diabetes. Examines how unhealthy lifestyle patterns put older adults at risk [weight gain] of type 2 diabetes.
Quantitative, Qualitative (How do you know?) Qualitative- it is an observational study. Quantitative- it is a focus group study. Quantitative- it is a longitudinal study.
Purpose Statement The study investigates how participation in MOVE is associated with reduced incidence of diabetes. The study explores the beliefs and attitudes of older adults and carers on deprescribing. This study examines the relationship between diet soda intake and long-term waist circumference change.
Research Question Does participation in lifestyle change programs reduce diabetes in older adults? Does doing away with pharmacological interventions do more harm than good in diabetes management among older adults? Does diet soda intake increase weight in older adults putting them at risk of type 2 diabetes?
Outcome Diabetes can be managed by positive lifestyle changes. Non-pharmacological approaches are more impacting depending on the interventions used. Type 2 diabetes can be managed by healthy dietary patterns.
Setting

(Where did the study take place?)

An outpatient care setting for veterans New South Wales, Australia San Antonio, Texas, neighborhoods
Sample 238540 individuals participated 14 older adults and 14 carers 749 adults- 65 years and above
Method Jackson et al. (2015) did a retrospective observational analysis of obese patients with weight-related disorder. Four focus groups of 14 older adults and 14 carers were conducted with additional conventional content analysis. Prospective cohort study
Key Findings of the Study Participation in MOVE program was associated with weight loss and reduced incidence of diabetes. Older adults would consider an alternative process since they dislike taking medications but fear since they are unaware of the outcomes. Weight circumference increases with diet soda intake (DSI) with the most affected group being daily users.
Recommendations of the Researcher Older adults should actively participate in lifestyle change programs to keep them safe from type 2 diabetes. Older adults should be advised on the various non-medical interventions available for diabetes management to keep them away from the risks of too much medication. DSI should be regulated as a way of avoiding escalating abdominal obesity that causes diabetes.

 

Criteria Article 4 Article 5 Article 6
APA-Formatted Article Citation with Permalink Carolan, M., Holman, J., & Ferrari, M. (2015). Experiences of diabetes self‐management: a focus group study among Australians with type 2 diabetes. Journal of clinical nursing24(7-8), 1011-1023. https://doi.org/10.1111/jocn.12724 Harris, M. L., Oldmeadow, C., Hure, A., Luu, J., Loxton, D., & Attia, J. (2017). Stress increases the risk of type 2 diabetes onset in women: A 12-year longitudinal study using causal modelling. PloS one12(2), e0172126. https://doi.org/10.1371/journal.pone.0172126

 

Xu, G., Liu, B., Sun, Y., Du, Y., Snetselaar, L. G., Hu, F. B., & Bao, W. (2018). Prevalence of diagnosed type 1 and type 2 diabetes among US adults in 2016 and 2017: population based study. Bmj362, k1497. https://doi.org/10.1136/bmj.k1497
How Does the Article Relate to the PICOT Question? It looks at the connection between the approaches used after diagnosis and outcomes in diabetes management. Examines some of the factors that put older people at risk of type-2 diabetes and how it can be avoided through lifestyle approaches. Examines the prevalence of diabetes in the US general population and effective management approaches.
Quantitative, Qualitative (How do you know?) Qualitative- it is an exploratory qualitative design. Quantitative- it is a longitudinal study Qualitative- it is a cross-sectional survey.
Purpose Statement The study examines the experiences of individuals with type 2 diabetes in a low-economic social setting. The study examines the relationship between perceived stress and type 2 diabetes onset. The study examines the proportion of each among US adult diagnosed with diabetes.
Research Question Are older adults from low socio-economic backgrounds at risk of type 2 diabetes mismanagement? Does stress increase the chances of getting type 2 diabetes in older adults? Do lifestyles play any role in increasing diabetes prevalence?
Outcome Many patients in low socio- economic backgrounds need support on self-management efforts. Stress and type 2 diabetes have a direct relationship. Lifestyles and the prevalence of diabetes are directly connected.
Setting

(Where did the study take place?)

Local health settings in Australia Australia- Women were randomly sampled through the Medicare Australia database. National Health Interview survey [2016-2017]
Sample 22 individuals with type 2 diabetes 12,844 women completed the study’s surveys. 58186 adults
Method Focus groups were used to collect data. A longitudinal study on women’s health. Cross sectional survey
Key Findings of the Study Patient experiences on diabetic management vary according to the socio-economic setting. Avoiding stress is one way of improving lifestyle and plays a critical role in avoiding or reducing the rates of type 2 diabetes. Factors that shape lifestyles such as education and race affect the prevalence of type 2 diabetes.
Recommendations of the Researcher Self-management approaches improve the management of type 2 diabetes and lifestyle approaches should be encouraged. Perceived stress is a strong risk factor for type 2 diabetes, and should be avoided as part of improving diabetes self-management. People should be educated on diabetes self-management practices since the prevalence is likely to increase as time advances..

 

 

References

Carolan, M., Holman, J., & Ferrari, M. (2015). Experiences of diabetes self‐management: a focus group study among Australians with

PICOT Question And Literature Search
PICOT Question And Literature Search

type 2 diabetes. Journal of clinical nursing24(7-8), 1011-1023. https://doi.org/10.1111/jocn.12724

Fowler, S. P., Williams, K., & Hazuda, H. P. (2015). Diet soda intake is associated with long‐term increases in waist circumference in a biethnic cohort of older adults: the San Antonio Longitudinal Study of Aging. Journal of the American Geriatrics Society63(4), 708-715. https://doi.org/10.1111/jgs.13376

Harris, M. L., Oldmeadow, C., Hure, A., Luu, J., Loxton, D., & Attia, J. (2017). Stress increases the risk of type 2 diabetes onset in women: A 12-year longitudinal study using causal modelling. PloS one12(2), e0172126. https://doi.org/10.1371/journal.pone.0172126

Jackson, S. L., Long, Q., Rhee, M. K., Olson, D. E., Tomolo, A. M., Cunningham, S. A., Ramakrishnan, U., Narayan, K. M., & Phillips, L. S. (2015). Weight loss and incidence of diabetes with the Veterans Health Administration MOVE! lifestyle change programme: an observational study. The lancet. Diabetes & endocrinology3(3), 173–180. https://doi.org/10.1016/S2213-8587(14)70267-0

Reeve, E., Low, L. F., & Hilmer, S. N. (2016). Beliefs and attitudes of older adults and carers about deprescribing of medications: a qualitative focus group study. Br J Gen Pract66(649), e552-e560.doi: https://doi.org/10.3399/bjgp16X685669

Xu, G., Liu, B., Sun, Y., Du, Y., Snetselaar, L. G., Hu, F. B., & Bao, W. (2018). Prevalence of diagnosed type 1 and type 2 diabetes among US adults in 2016 and 2017: population based study. Bmj362, k1497. https://doi.org/10.1136/bmj.k1497

Yakaryılmaz, F. D., & Öztürk, Z. A. (2017). Treatment of type 2 diabetes mellitus in the elderly. World journal of diabetes8(6), 278–285. https://doi.org/10.4239/wjd.v8.i6.278

Topic 5 DQ 2

Aug 22-26, 2022

According to the textbook, nurses in various settings are adopting a research-based (or evidence-based) practice that incorporates research findings into their decisions and interactions with patients. How do you see this being applied in your workplace? In addition, how can you strive to make spirituality and self-care a practice for your patients as well as yourself? How does this practice align with the Christian worldview?

Justina Aguilar

Aug 26, 2022, 11:40 PM

Replies to Justina Aguilar

Nurses use EBP to provide patients with safe, quality care and to improve outcomes. When developing EBP, one is looking at research already conducted (Helbig, 2018). My employer uses EBP for hospital-wide wide patient care. For example, I work on a GI floor. Our patients receive new ileostomy or colostomy placements regularly. However, EBP shows enhanced recovery is better than traditional recovery methods. We encourage our patients to ambulate within 4 hours post-op, intake 500mls within 8 hours post-op, and start patients off on a regular diet. Most patients are educated before surgery.

Workplace spirituality in nursing is mostly defined and researched from the individual viewpoint. The definition includes dimensions of inner life, meaningful work, interconnectedness, transcendence, and alignment between values (Pirkola et al., 2016). A sense of community and meaningful work are the most important dimensions of workplace spirituality in health care.

My goal is to view every shift as 12 hours to make a difference in my patients’ lives. Not just the medical part of the tasking and the critical thinking that comes naturally. But to give my patients the TLC they need in this, their hardest hour. They are down, ill, alone at night. I develop a rapport with them and make sure they are as comfortable as possible. I help them get clean, and pain-free (if possible), meet needs, tidy the room, clarify the night’s plan of care, and expectations from me, and make sure the patient and I are on the same page as far as the doctor’s plan. This may be reiterating the day Ds notes. I offer prayer if appropriate. I always offer a warm blanket, fan, and/or aromatherapy. I do my best to give holistic care and treat each patient with the utmost dignity and respect.

Selfcare is a personal struggle, to be honest. I do need to prioritize “me” time more than I do. I truly feel guilty not spending my extra time with my family since I’m so tired with the night shift and school all the time. I try and use any extra time to be with my family. I want to start going for 30-minute walks daily. It’s been a personal goal for a while.

When it comes to my Christian worldview, I try to treat others the way I want to be treated. It’s a simple rule, but it works for my personal and professional life. I try every day to be a better human than the day before. I am not a perfect mom, wife, sister, daughter, best friend, student, nurse, tia, or daughter-in-law, but I do my best. I do have a personal relationship with my savior. I know where I’m going when my earthly days are done. I’m confident with my actions on earth. I do my best, that’s all we can do.

 

Reference

Helbig, J. (2018). Nursing research: Understanding methods for best practice. Retrieved from https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1

Pirkola, H., Rantakokko, P., & Suhonen, M. (2016). Workplace spirituality in health care: an integrated review of the literature. Journal of nursing management24(7), 859–868. https://doi.org/10.1111/jonm.12398