Main Post: Discussion – Week 4
Searching Databases
The PICO(T) format is often used to construct a question, when performing research on a given subject. This format allows a person to effectively search within academic databases. For this course, I have chosen diabetes mellitus as my clinical area of interest. Through research and clinical inquiry, we can educate ourselves on current best practices (Walden University, LLC. (Producer), 2018). The PICO(T) format addresses the patient or population, intervention, comparisons, possible outcomes and timeframe (Davies, 2011).
When a person is first diagnosed with diabetes mellitus, they may wonder how this diagnosis will change their life, diet and what treatment options are available. However, some people may not understand the extent of this diagnosis. They may also lack the proper education needed to properly manage this disease. For conservative treatment, some people choose to adopt a healthy diet that is low in sugar and carbohydrates, rather than taking diabetic medications, within reason. Once on this diet, or if they choose to take medication, they can begin tracking their blood glucose levels and hemoglobin A1C. For this assignment, I have built the following question using the PICO(T) format: For diagnosed diabetic patients, how effective is a diet low in carbohydrates and sugar compared to diabetic medications at managing a person’s blood glucose levels throughout the day?
To search for answers for this question, I chose to use the Ovid Nursing Journals with Full Text as the database to begin my search. I chose this database because it has a focus on the nursing practice. To start my search, I simply typed, “diabetes treatment” and searched for keywords. A person may also choose to use the Boolean operators to further refine their search (Library of Congress, n.d.). These options may be found in the advance search engine (n.d.). This preliminary search yielded seven hundred and four text results. To increase the effectiveness of my database search and to find the most recent information, I chose to limit my research to the last five years. I also selected to view articles as the publication type. This search narrowed the text down to two hundred and four articles. In research, I believe that sometimes less is more. Looking at thousands of articles at once can be an overwhelming amount of information. I prefer to use the advanced search option to create a sense of focus, when finding information.
References:
Davies, K. S. (2011). Formulating the evidence based practice question: A review of the
frameworks for LIS professionals. Evidence Based Library and Information Practice, 6(2), 75–80.
Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting.
Retrieved September 19, 2018, from
https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html
Walden University, LLC. (Producer). (2018). The Value of Clinical Inquiry [Video file].
Baltimore, MD: Author.
9 months ago
Mary Bemker-page WALDEN INSTRUCTOR MANAGER
RE: Main Post: Discussion – Week 4
You explain the importance of your topic and your interest in such. This topic is one of concern, as you note, due to the high percentage of individuals who may contract this disease while hospitalized. What Boolean terms provided the most impact for your search? What leads you to believe this?
Dr. B.
9 months ago
hope Davis
RE: Discussion – Week 4
According to an online article, “PICOT question format is a consistent formula for developing answerable, researchable questions (Physician assistant: What is a Picot question?). In addition, it makes finding and evaluating evidence much more straightforward.
Healthcare experience various stressors that need to be addressed to improve patient care. Stressors cause an emotional and physical toll on healthcare workers. Some of the stressors need to be addressed first because of their impact on patient outcomes and healthcare workers. The national healthcare stressor selected is a higher patient-nurse ratio. The higher patient-nurse percentage needs to be addressed because it leads to unsafe healthcare practices. The patient-nurse ratio refers to the number of patients that a nurse provides care for at one time.
In the organization I work, the number of patients that one nurse cares for at a time has increased. The increasing aging population and baby boomers are causing staffing shortages in the healthcare setting. Nurses are required to attend to many patients simultaneously, which leads to adverse patient outcomes. The high patient-nurse ratio has been in existence for many years. A minimum number of patients that registered nurses must attend to should be established. Establishing a minimum number of patients assigned to nurses will increase positive patient outcomes and minimize the chances of nurse burnout, medical errors, and nurse job satisfaction. Additionally, a high patient-nurse ratio leads to many nurses quitting the profession resulting in increased use of resources by the health facility to hire new staff.
I searched the primary search box under advanced search to find the information needed for my clinical interest. In return on Higher-nurse patient ratio search, I got 325 results. I then used the database CINHAL plus with full text. The results I received were seven.
When searching for information while writing on my clinical issue of interest, I have to narrow the topic down and be more specific with what I am looking for to get the accurate information I need. Therefore, I also have to use CINHAL plus full text as it narrows down to specific databased for the research. (Walden.edu, 2022).
References
Cole, A. (2014). Research shows that higher nurse-to-patient ratios on stroke units could cut one death in 25. BMJ (Clinical Research Ed.), 349, g5260. https://doi.org/10.1136/bmj.g5260
Griffiths, P., Recio‐Saucedo, A., Dall’Ora, C., Briggs, J., Mariotti, A., Meredith, P., … & Missed Care Study Group. (2018). A systematic review is the association between nurse staffing and omissions in nursing care. Journal of advanced nursing, 74(7), 1474-1487
Physician assistant: What is a Picot question? Subject Guides. (n.d.). Retrieved March 23, 2022, from https://laverne.libguides.com/c.php?g=596152&p=6938557
8 months ago
Inderpreet Sandhar
RE: Discussion – Week 4
Great post this week Hope,
The PICOT format is set up so you can form a clinical question that would help your searching process easier. According to Melnyk & Fineout-Overholt (2019), the purpose of the PICOT question is to guide the systematic search of healthcare databases to find the best available evidence to answer the question.
I searched through numerous databases such as Walden Library, PubMed, and CINAHL with full-text databases because these databases are noted to be the most comprehensive. The strategy I would use is to formulate and brainstorm a PICOT question, search different databases, and use other keywords or opposite words. The use of Boolean operators and nest search engines enabled a combination of words or phrases which resulted in more specific research results. The benefit of Boolean operators improves the findings of searches, which in turn helps millions who surf the web every day (papiewski, 2015).
References:
Melnyk, B. M. % Fineout-Overholt, E. (2019). Evidence-Based practice in nursing &healthcare: A guide to best practice (4th Ed.) Wolters Kluwer.
Papiewski, J. (2015). Advantages &disadvantages of Boolean logic Sciencing. https://sciencing.com/advantages-disadvantages-boolean-logic-12115642.html
9 months ago
Crystal Anderson
My Initial Post
The clinical issue I wanted to investigate is nurse burnout and the impact nurse burnout has on patient quality of care. Nurse burnout is the exhaustion of physical or emotional strength or motivation, usually because of prolonged stress or frustration which is a widespread phenomenon (Mudallal, et at, 2017). Nursing as a profession lately has become a bit overwhelming especially in inpatient acute care hospital settings during the COVID-19 pandemic. Floors are short, money and materials are limited which creates an unpleasant work environment at times. A few signs and symptoms of nurse burnout are depression, fatigue, headache, insomnia, negative feelings associated toward working as a nurse. I chose this clinical issue because I am a strong believer of providing great quality care to my patients and personally feel I am going through nurse burnout, and I wonder how the care I give now compares to care I gave to my patients a few years back. According to WHO Health Organization quality care is the degree in which health services for individuals and populations increase the likelihood of desired health outcomes. Quality of care is based on evidence-based professional knowledge (World Health Organization, 2022).
I always start my research with Google Scholar. This search engine helps me come up with key words to help start research and using keywords to help create keywords to look for journal articles. For example, Google Scholar helps provide a simple way to broadly search scholarly literature such as articles, books, abstracts, and court opinions. Google scholar aims to rank documents the way researchers do by weighing the full text of each document, where the article was published and who it was written by. In google scholar I searched nurse burnout and patient quality of care and then used the specific time frame box to look at articles within the last 5 years. This ensures that information current. Walden University provides access to several different databases. According to Walden University Library a few drawbacks from using google scholar articles have no peer review limit which makes it hard to see original articles, also Google scholar has no full-text limit and can be hard to do complex searches. I look forward to doing more research on nurse burnout and the impact it has on patient quality of care.
Walden University. (2021). Why use google scholar? Retrieved from https://academicguides.waldenu.edu/library/googlescholar
Mudallal, R. H., Othman, W. M., & Al Hassan, N. F. (2017). Nurses’ Burnout: The Influence of Leader Empowering Behaviors, Work Conditions, and Demographic Traits. Inquiry: a journal of medical care organization, provision, and financing, 54, 46958017724944. https://doi.org/10.1177/0046958017724944
World Health Organization. (2022). Quality of care. https://www.who.int/health-topics/quality-of-care#tab=tab_3
9 months ago
Mary Bemker-page WALDEN INSTRUCTOR MANAGER
RE: My Initial Post
I appreciate the manner in which you combine literature and personal experience. When we look to assessment and planning, it is important to apply best practice information to the situation in which we find ourselves. Thank you for this insight.
Dr. B.
9 months ago
Matthew Cluderay
RE: My Initial Post
Crystal,
No doubt nurse burnout has been an issue for the profession for many years. I peeked in the Walden Library resources to see how many articles could be appropriate to help remedy the problem. Searching using those Boolean terms and adding “+remediation” to the original search of nurse burnout there are 7 articles accessible in the library (Library of Congress n.d.).
I never used google scholar to start research but after seeing your post, I looked into it and I think it’s something I should use more of. Using it to help come up with key word searches is certainly beneficial. Thanks for your input and have a nice weekend
-Matt
Library of Congress. (n.d.). Search/browse help – Boolean operators and nesting. Retrieved September 19, 2018, from https://catalog.loc.gov/vwebv/ui/en_US/htdocs/help/searchBoolean.html
Walden University. (2021). Why use google scholar? Retrieved from https://academicguides.waldenu.edu/library/googlescholar
9 months ago
Shirley Harleston
RE: My Initial Post
Hello Crystal,
I appreciate you giving your perspective on nurse burnout during the COVID 19 Pandemic. I happen to know nurses who lost their lives during this period and also a lot of nurses had to quit their jobs because they could not handle the stress. “The COVID-19 pandemic had a massive impact on health care systems, increasing the risks of psychological distress in health professionals.” (Jose, S., et al, 2020). Some nurses could not deal with the situation and they also did not feel valued by their employers.
Nursing administration has to provide a positive and healthy environment for nurses. I believe that incentives are crucial to nursing retention. Most nurses that left their jobs ended up working for agencies that paid them a lot of money. What are your thoughts on monetary incentives for nurses?
Burnout is caused by so many factors, it is a complicated problem and should be treated in a variety of ways and by combining interventions. (Aryankhesal, A. et al 2019).
References:
Aryankhesal, A., Mohammadibakhsh, R., Hamidi, Y., Alidoost, S., Behzadifar, M., Sohrabi, R., & Farhadi, Z. (2019). Interventions on reducing burnout in physicians and nurses: A systematic review. Medical journal of the Islamic Republic of Iran, 33, 77. https://doi.org/10.34171/mjiri.33.77
Jose, S., Dhandapani, M., & Cyriac, M. C. (2020). Burnout and Resilience among Frontline Nurses during COVID-19 Pandemic: A Cross-sectional Study in the Emergency Department of a Tertiary Care Center, North India. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 24(11), 1081–1088. https://doi.org/10.5005/jp-journals-10071-23667
8 months ago
Sharon Muchina
RE: My 2nd response to Crystal
Hi Crystal. You chose an engaging topic connected to an issue many nurses are currently facing.
We can educate ourselves on current best practices through research and clinical inquiries (Walden University, LLC. (Producer), 2018). Therefore, I wanted to suggest using the (CINAHL) Cumulative Index to Nursing & Allied Health Literature and MEDLINE search which looks for peer-reviewed articles, reports of evidence-based practice, and case studies.
Also try constructing a PICO(T) question to help you find the desired peer-reviewed research on this topic. The PICO(T) format allows you to assess your P: Patient or Population, Problem, I: Intervention, C: Comparisons, O: Outcomes, and T: Timeframe (Davies, 2011). Hopefully, this narrows your search outcomes/ results based on the assessment findings within the PICO(T) analysis.
References
Davies, K. S. (2011). Formulating the evidence-based practice question: A review of the
frameworks for LIS professionals. Evidence Based Library and Information Practice, 6(2), 75–80.
Walden University, LLC. (Producer). (2018). The Value of Clinical Inquiry [Video file]. Baltimore, MD: Author.
8 months ago
Kehinde Tade
RE: Response 2
Hi Crystal,
I like your discussion post, very interesting. I am so glad that you shed some light on nursing burnout. The nursing shortage and burnout are serious clinical issues that are continuing to escalate. Nursing positions are trending to rise about 15% within the next decade, the demand for a nurse is not enough to keep up with the substantial increase in the population (U.S. Bureau of labor statistics,2021). Six strategies recommended to increase the rigor and effectiveness of a database search for PICOT questions include: theorize your search, appropriate vocabulary use, use of Boolean terms that combine terms and concepts, search strategy revision, utilization of more than one database, and acquisition of the database search rules and particularities (The University of Texas, 2019). Increasing the rigor and effectiveness of the database search require strategies, including replacing the terms too general and searching using a combination of databases.
In addition to setting time and frame, a search can also be improved using Boolean terms also known as command terms which connect the keywords to create a logical phrase that the database can understand (Melnyk& Fineout-Overholt,2018). This may involve telling the database to look for multiple terms or concepts at once, which will make your search more precise.
References
U.S. Bureau of Labor Statistics. (2021, February A18).Registered Nurses: Occupational Outlook Handbook. https://www.bls.gov/ooh/healthcare/registered-nurses.htm
Melnyk, B., & Fineout-Overholt, E. (2019). Evidence-based Practice in Nursing & Healthcare (4th ed.). Wolters Kluwer.
The University of Texas. (2019, July 23). Best practices for developing search strategies: Home. https://libguides.sph.uth.tmc.edu/c.php?g=543359
9 months ago
Claudia Paz
RE: Discussion – Week 4
9 months ago
Sharon Muchina
RE: Discussion – Week 4
Childhood obesity remains a significant public health concern (Johnson al., 2016). I will address if having a school-based intervention program over one year period than not having one affects the health outcomes of obese adolescents ages 13-19.
I looked for scholarly articles at the Ovid multi-field search, which has a collection of full-text nursing journals. By typing the keywords from the PICO (T) questions on the three available search spaces, P (Problem/Patient/Population) was obesity and adolescents 13- 19 years (which I tried both words together and separately). I (intervention) was the school programs. There were no results to these searches. I then tried the basic search option and used keywords and the Boolean operators, and was able to get outdated articles over five years old. I found no search results after setting up the limits on the publications per the dates and age requirements.
I then tried the (CINAHL) Cumulative Index to Nursing & Allied Health Literature and MEDLINE combined search to look for four peer-reviewed articles, reports of evidence-based practice, and case studies. This database gave sixteen articles whose abstracts were not directly related to the topic. Therefore, I combined keywords related to the topic of interest, like obesity and adolescents, using the asterisk (*) to truncate after the keywords. I used Boolean operators such as “and, or” to combine words and phrases, but I did not use “not” because I did not want to exclude any key terms I was searching for related to this topic.
One of the four articles I found relevant to the topic uncovered that school programs could affect obesity in adolescents by providing physical activity, and quality food options, for students ages 13- 19 years old (Liew, 2018).
There are many databases for searching for scholarly publications and research journals. The key is learning how to use one search engine well and learning the required key terms (Laureate Education (Producer). (2018), n.d.) To increase the rigor and effectiveness of finding desired outcomes of the PICO(T) question, I will again utilize the (CINAHL) Cumulative Index to Nursing & Allied Health Literature and MEDLINE databases. This database gives peer-reviewed journal articles, and the research has been done recently within the last five years.
References
Johnson, P., Montgomery, M. & Ewell, P. Federal Food Assistance Programs and Cardiovascular Risk Factors in Low-Income Preschool Children. J Community Health 41, 626–634 (2016). https://doi.org/10.1007/s10900-015-0138-6
Laureate Education (Producer). (2018). (n.d.). Searching the Evidence [Video]. Walden University. Laureate Education (Producer). (2018). Research Methodologies [Video file]. Baltimore, MD: Author.
Liew, H.-P. (2018). Dietary habits and physical activity: Results from cluster analysis and market basket analysis. Nutrition and Health, 24(2), 83–92. https://doi.org/10.1177/0260106018770942
9 months ago
Mary Bemker-page WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 4
Thank you for breaking this process down into such dynamic terms. Knowing the steps needed to complete a task is paramount to success, and sharing these steps demonstrates your understanding as well. What one dynamic do you think would have assisted in improving this experience for one new to this process?
Dr. B.
8 months ago
Sharon Muchina
RE: Discussion – Week 4
8 months ago
Mary Bemker-page WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 4
This is a good point.
Thank you for your insights.
Dr. B.
8 months ago
Sharon Muchina
RE: Discussion – Week 4
You are welcome Dr. B.
Have a great weekend.
Sharon Muchina
8 months ago
Claudia Paz
RE: Discussion – Week 4
Hi Sharon,
Childhood obesity is a prominent topic. It is an ongoing battle that is hard to win because the nutrients provided in schools are not the most healthiest. Proper nutrition in the home also adds to the problem because their are many low-income families that can not afford to buy healthy food. Now a days, it is cheaper to buy a bag of chips then it is to buy a bag of apples.
As nurses, we have been trained to do what is company policy and have not fully questioned as to why we do such things (Melnyl et al., 2009). Evidence-based practice has lead the way for nurses to truly ask, where is the evidence that proofs this to be true. As healthcare providers we should be researching what EBPs have been proven to prevent and treat childhood obesity. You don’t have to be a rocket scientist to figure out that nutrition and physical activity play a huge part in this problem. Often, parents need proof that certain methods work better than others because the parent was brought up in believing such things. This is where EBP proves the opposite and leads the way for change in society.
When searching for articles, I always start with the CINAHL database. I did not know that by checking the “suggest subject terms” box will only provide articles with a subject heading (Melnyl & Fineout-Overholt, 2019). Nonetheless, it is an extremely useful website that has over 70 full-text articles and can only be accessed through a subscription (Melnyl & Fineout–Overholt, 2019).
Reference
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
Melnyk, B.M., Fineout-Overholt, E., Stillwell, S.B., & Williamson K.M. (2009). Evidence-based practice: Step by step: Igniting a spirit of inquiry. American Journal of Nursing, 109(11). 49-52. doi: 10.1097/01NAJ.0000363354.53883.58
8 months ago
Sharon Muchina
RE: Discussion – Week 4
You make an excellent point, Claudia, that I had not even thought that parents tend to provide the same diet they were accustomed to eating themselves, even though some diets might not be nutritious. Parents can influence food preferences and self-regulation of dietary intake by youth (Riebl et al., 2016). The objective is for parents to model good deity behaviors, but also this is where the value of education based on EBP is essential.
References
Riebl, S. K., MacDougal, C., Hill, C., Estabrooks, P. A., Dunsmore, J. C., Savla, J., … & Davy, B. M. (2016). Beverage choices of adolescents and their parents using the theory of planned behavior: a mixed-methods analysis. Journal of the Academy of Nutrition and Dietetics, 116(2), 226-239.
9 months ago
April Williams
RE: Discussion – Week 4
9 months ago
Mary Bemker-page WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 4
9 months ago
Sharon Muchina
RE: Discussion – Week 4
9 months ago
April Williams
RE: Discussion – Week 4
Great advice, I have been working on my PICOT question and looking to narrow it down. The problem is narrowing it down when there are so many problems to address. I will use you suggestion regarding search engine. Thank you
8 months ago
Sharon Muchina
RE: Discussion – Week 4
9 months ago
Rona Adams
RE: Discussion – Week 4
Main Discussion Post
The clinical issue of interest is anxiety affecting young adolescents. This topic is critical to me because several family members and friends develop anxiety from social isolation during the Covid 19 pandemic. Many adolescents became withdrawn, depressed and anxious when the nation was on lockdown. They could not socially engage with peers, attend school, or participate in recreational activities (i.e., sports, hanging out with friends, etc.). According to Chen et al., 2020, young people must receive early intervention when they have anxiety and depression because it could persist in high-risk factors of heart disease, obesity, and other age-related diseases later on in adulthood.
PICOT is an approach to help formulate a research question to investigate the area of interest further and obtain relevant research information based on previous literature (Zheng et al., 2012). Melnyk & Fineout-Overholt reported that the clinical question is formatted in a mnemonic “(P-patient population, intervention or issue of interest, comparison intervention or group, outcome and time frame)” (2018). The following is my PICOT format related to my clinical issues of interest: In anxiety adolescents (P), how do regular therapy sessions (C) compare to medication management (O) reduce anxiety symptoms (T) in a six-month timeframe.
After formulating my PICOT question, I used Walden University Library EBSCO advanced search and keyed in my words, and made sure I checked “peer-reviewed scholarly journals.” The investigation leads me to 368 articles on my area of interest. However, before using the PICOT question during my initial search, I had over 530 articles. The second research data I used was Google Scholar inputting “anxiety adolescents” and therapy and medication, revealing 1370 results. When I entered my PICOT question my results revealed over 17100 hits from Google Scholar. Using the PICOT question in CINAL Plus with full text—I received 100,771 results. Next, I went to Pubmed and entered anxiety adolescents and treatment and therapy and medication; set filters to articles within 5 years, free full text and obtained 1425 reveals.
References
Chen, F., Zheng, D., Liu, J., Guan, Z., & Lou, D. (2020, August). Depression and anxiety among adolescents during covid-19: A cross-sectional study. https://www.sciencedirect.com/science/article/pii/S0889159120308916?via%3Dihub
Melnyk, B., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice (Fourth, International ed.). Lippincott Williams and Wilkins.
Riva, J. J., Malik, K. M., Burnie, S. J., Endicott, A. R., & Busse, J. W. (2012). What is your research question? An introduction to the PICOT format for clinicians. The Journal of the Canadian Chiropractic Association, 56(3), 167–171.
9 months ago
Marissa Ludwig
RE: Discussion – Week 4
Hi Rona,
I found your clinical issue very interesting. As a young adult myself, the pandemic had a significant impact on my mental health. The pandemic has increased stress levels for numerous people; however, many people are also prone to an increase in anxiety and depression, especially adolescents and young adults (Morales et al., 2022). One contributing factor to this increase was the lifestyle transformation (Chen et al., 2020). The sudden shift from going to school, being surrounded by friends, and participating in activities every day to staying home 24/7 impacted many people’s lives. I wonder if, as the pandemic is slowing down, will some of the mental health changes persist in adolescents and young adults?
References
Chen, F., Zheng, D., Liu, J., Gong, Y., Guan, Z., & Lou, D. (2020). Depression and anxiety among adolescents during COVID-19: A cross-sectional study. Brain, Behavior & Immunity, 88, 36–38. https://doi.org/10.1016/j.bbi.2020.05.061
Morales, S., Zeytinoglu, S., Buzzell, G. A., Valadez, E. A., Troller-Renfree, S. V., Bowers, M. E., Chronis-Tuscano, A., Degnan, K. A., Almas, A. N., Pine, D. S., & Fox, N. A. (2022). Neurocognitive Profiles in Adolescence Predict Subsequent Anxiety Trajectories During the COVID-19 Pandemic. Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, 7(2), 192–200. https://doi.org/10.1016/j.bpsc.2021.06.004
8 months ago
Rona Adams
RE: Discussion – Week 4
Marissa,
Thank you for responding. I believe since the pandemic is winding down many people will start to feel better. Some people are still in denial about their mental health issues and can’t explain why they are angry or moody.
8 months ago
April Williams
RE: Discussion – Week 4
Hello Rona,
You have selected a good topic for research. Anxiety can be paralyzing, especially in adolescent children. I found it surprising when you used the PICO search it retrieved over 100,000 articles. It would take more than a year to go through that many articles. In attempting to research your topic, I read article that concluded anxiety symptoms improved after a single session of individually tailored therapy, however, long-term research was needed to determine the effectiveness of the results (Cardomone-Breen et al., 2018). This made me think about how the results will be measured and at what timeframes. For example, in a 6-month period, the results could be positive in one month and three months, but at 6-months the patient could have peak improvement with baseline results declining. If this cases, one area to think about when reviewing the research.
You are ahead of the curve in already beginning to develop your PICOT questions. In the Stillwell et al (2010), there is a great example used to develop the POCOT question, laying out each area and sample wording that makes the PICOT read more smoothly. I recommend reviewing this example to assist and determine any opportunity to modify your PICOT. Again, great job and I look forward to seeing your finish product.
References
Cardamone-Breen, M. C., Jorm, A. F., Lawrence, K. A., Rapee, R. M., Mackinnon, A. J., & Yap,
- (2018). A Single-Session, Web-Based Parenting Intervention to Prevent Adolescent
Depression and Anxiety Disorders: Randomized Controlled Trial. Journal of medical
Internet research, 20(4), e148. https://doi.org/10.2196/jmir.9499
Stillwell, S. B. , Fineout-Overholt, E. , Melnyk, B. M. & Williamson, K. M. (2010). Evidence-Based
Practice, Step by Step: Searching for the Evidence. AJN, American Journal of
Nursing, 110 (5), 41-47. doi: 10.1097/01.NAJ.0000372071.24134.7e
9 months ago
Adetokunbo Oluwatuyi
RE: Discussion – Week 4
PICO(T)
The PICO(T) question format involves elements of clinical research questions in which P is for the patient, I is for intervention, C is for comparison, O is for Outcome, and lastly, T is for Time, it is in brackets because is it involved in some cases (Formulating a PICOT Question: Duquesne University, 2020).
Clinical Issue of Interest
My clinical issue of interest is Alzheimer’s disease in the elderly population. Alzheimer’s disease is a progressive neurologic disease that impairs mental functions such as the memory of individuals that are affected (Mayo Clinic Staff, 2022).
PICO(T) Question
In patients of the elderly population with Alzheimer’s disease, person-centered healthcare would be used to help maintain their memory, could also socialize patients with others to help them stay connected with the world, in hopes of reducing the symptoms of the disease. I used the Medline and ProQuest databases to help with my PICO(T) question.
Database Search Results
My search results were a lot after my original research, some were unnecessary, so the Boolean operators helped me narrow them down to what I was looking for. To increase the database rigor and effectiveness by using boolean operators, using the appropriate vocabulary, and also using more than one database (How do you increase rigor and effectiveness of a database search, 2021).
References
Formulating a PICOT Question: Duquesne University. Duquesne University School of Nursing. (2020, September 26). Retrieved March 23, 2022, from https://onlinenursing.duq.edu/blog/formulating-a-picot-question/#:~:text=The%20word%20PICOT%20is%20a,phrased%20to%20elicit%20an%20answer.
How do you increase rigor and effectiveness of a database search? Blog About Academic Writing. (2021, December 18). Retrieved March 23, 2022, from https://www.hotels-in-budapest-hungary.com/how-do-you-increase-rigor-and-effectiveness-of-a-database-search/
Mayo Clinic Staff. (2022, February 19). Alzheimer’s disease. Mayo Clinic. Retrieved March 23, 2022, from https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/symptoms-causes/syc-20350447
9 months ago
Mary Bemker-page WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 4 Information on Obtaining an Article From the Library
I just dropped a video into the announcements regarding how to obtain the article that has a link not working this week. Please review as needed.
Dr. B.
9 months ago
Mary Bemker-page WALDEN INSTRUCTOR MANAGER
RE: Discussion – Week 4
I often get questions from students regarding the assignment noted in this module, so I wanted to offer some additional insights here. I developed the following in hopes that it can be of assistance.
To develop a PICOT question, it is important that the correct content is connected to each area of the question.
Your preliminary PICOT question and a description of each PICOT variable relevant to your question are paramount to a solid evidence-based investigation.
Please see the following for information on your PICOT question:
https://laureatena-my.sharepoint.com/:p:/g/personal/mary_bemker_mail_waldenu_edu/Edoc1TY96p9CrR6h-22ZpnMBixrr72CuOjhwcgzkJzNQRQ?rtime=A1DzE13z1kg
In the past, several students asked about how to address PICOT questions in a specific direction. A variety of focused PICOT questions will be offered here for your consideration:
When considering a question linked to prevention or intervention, one might say:
In adolescents, 13-15 years of age, how does education by the school nurse compares with groups led by peer mentors in alcohol consumption?
In individuals with a substance use disorder, how does cognitive behavioral therapy compare with life regression therapy in relapse prevention?
When considering a question linked to etiology, one might say:
Are adults, over the age of 25, with a history of alcoholism in their immediate family, compare with those without any immediate family with an alcohol use disorder, at greater risk for developing an alcohol use disorder if social drinking is initiated?
Are adult children of alcoholics (ACOA) who exhibit a genetic predisposition for chemical dependency compare with ACOAs without the genetic predisposition for substance abuse disorders at an increased risk for developing an alcohol abuse disorder>?
When considering a question linked to health prediction, one might say:
In patients who have received an alcohol use disorder diagnosis, how does the use of Declinol compare to not receiving any pharmaceutical intervention when first attempting to stop drinking alcoholic beverages?
In middle-aged females suspected of an alcohol use disorder, are health interviews, as compared to using the “AUDIT” screening instrument, more accurate in predicting health consequences related to alcohol use?
When considering a question linked to meaning, one might say:
How do individuals with a diagnosis of an alcohol use disorder, perceive their responsibility for consequences linked to alcohol use before recovery?
- How do individuals raised in a family with a parent with an alcohol use disorder, perceive health issues linked to their own use of alcohol?
By providing these examples, I hope you can see how different dynamics can be applied based on the focus of your work. Please let me know if you have any questions.
Dr. B.
8 months ago
Christina Fisher
RE: Discussion – Week 4
While mental health awareness is on the rise, the number of mental health facilities is at an all-time low. According to NAMI, “46.2% of U.S. adults with mental illness received treatment in 2020” (2022). Mental health treatment should be standard, like going to a primary care physician. Coombs et al., states “, Mental health care is complicated due to lingering social stigmas and scarcity of services” (2021). Preventative mental health treatment could lead to a decrease in the stigma. It would open up more providers to screen for mental health issues and offer the resources necessary to decrease the number of inpatient mental health admissions.
P – Those with mental health issues
I – More preventative treatment
C – More preventative treatment as opposed to inpatient stays
O – Less strain on the inpatient facilities
T – Over a year
A PICO(T) question is “a systemic way to identify the components of a clinical issue” (Stillwell, 2010, p.59). Using this method to build a question helps gather all the necessary pieces to answer the question. After a year, a reevaluation could evolve the PICO(T) or make this a common practice.
In my search for resources for this topic, I searched multiple words and word combinations. My first search was “Lack of Mental Healthcare,” followed by “Barriers to Mental Health Services.” I then used the Boolean term “and” to decrease the number of results; I searched “Mental Health Services AND Accessibility” (Walden). While I found some of these helpful, the resulting rage was too large. I then used the Boolean term “not,” searching Mental Health Access NOT Adolescents” (Walden). To further narrow my search.
To increase my rigor and effectiveness in my search process, I would use synonyms and Boolean terms further to narrow my search for information about a specific topic. I would also use the broad search to help identify a subject based on the initial results of a broad search.
References:
Coombs N.C., Wyatt E. Meriwether, James Caringi, & Sophia R. Newcomer. (2021). Barriers to healthcare access among U.S. adults with mental health challenges: A population-based study. SSM: Population Health, 15(100847-). https://doi.org/10.1016/j.ssmph.2021.1
NAMI. (n.d.). Mental health by the numbers. Retrieved March 23, 2022, from https://www.nami.org/mhstats
Stillwell, S. B. , Fineout-Overholt, E. , Melnyk, B. M. & Williamson, K. M. (2010). Evidence-Based Practice, Step by Step: Asking the Clinical Question. AJN, American Journal of Nursing, 110 (3), 58-61. doi: 10.1097/01.NAJ.0000368959.11129.79.
Walden University Library. (n.d.). Keyword searching: Finding articles on your topic: CONNECT KEYWORDS. Academic Guides. (n.d.). Retrieved March 23, 2022, from https://academicguides.waldenu.edu/library/keyword/boolean
8 months ago
Brittni Rodio
RE: Discussion – Week 4
Discussion Two
Brito (2018) describes misgendering as intentionally or unintentionally referring to, or describing, someone in a way that does not align with their affirmed gender. Those within the transgender and non-binary community fall victim to this act most often, and it has been known to create a negative impact on victims’ mental health. However, research shows that using preferred pronouns and chosen names is linked to decreased suicidal ideation and other depressive symptoms (Russell et al., 2018). So, I decided to research the positive effects of gender affirming care, specifically the use of preferred pronouns and chosen names, for transgender and non-binary individuals in a health care setting.
Understanding the trials and tribulations of those within the transgender and non-binary community has been at the forefront of media and research over the last few years. This led to an exceptional amount of database results on CINHAHL Plus, APA PsycInfo, PubMed, and Medline, but it quickly became overwhelming. Thankfully, through the use of boolean terms I was able to decrease the amount of results I needed to sort through while increasing the relevance of the articles that did show up. Chosen name, misgendering, transgender, non-binary, health care, and mental health were the keyword variations I used with the boolean terms “and” and “or”.
The articles I chose were quite informative on misgendering, however, there is still room for improvement. In the future search limitations will be refined to become more in line with my PICOT question along with using keywords directly out of the PICOT question. These changes will increase the rigor and of effectiveness of my future database searches.
References
Brito, J. (2018, September 18). What does it mean to misgender someone?. Healthline Media. https://www.healthline.com/health/transgender/misgendering
Russell, S. T., Pollitt, A. M., Li, G., & Grossman, A. H. (2018). Chosen name use is linked to reduced depressive symptoms, suicidal ideation and behavior among transgender youth. Journal of Adolescent Health, 63(4), 503-505. https://doi.org/10.1016/j.jadohealth.2018.02.003
Walden University Library. (n.d.). Keyword searching: Finding articles on your topic: Boolean terms. Retrieved March 21, 2022, from https://academicguides.waldenu.edu/library/keyword/boolean