Using a PICO(T) Framework and Evidence to Develop Care Practices
Subject: Administration & Regulation
This paper will address a patient issue using the PICOT framework, which is a combination of Population/Patient, Intervention, Comparison, Outcome, and Time factors. Each element of the framework will be used to design a research question for an intervention to improve the well-being of patients with diabetes. Using secondary sources of data, the author will define a PICOT question for the patients with diabetes and use this evidence to answer the research question and evaluate the relevance of the findings for this population.
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Use of the PICO(T) Approach when Caring for Patients with Diabetes A practice issue that should be addressed with a PICOT question is the improvement of self-management skills for patients who have type II diabetes. Using the PICTOt framework, the following research question is established: In people with type II diabetes, can an internet-based educational intervention compared to no intervention improve the self-management skills in two weeks? This intervention is based on the principles of patient-centered care, where an individual’s experiences and personnel skills are more important than the objective capabilities of a healthcare provider to facilitate treatment. According to Kurnia et al. (2017), for patients with diabetes, a patient-centered approach is essential because chronic condition management relies on one’s ability to facilitate care. For the purpose of this study, the cultural, social, and political factors are omitted from consideration since the focus is on a patient’s abilities to manage diabetes outside a healthcare facility. Hence, only the patient’s knowledge and self-efficacy concerning diabetes management will be assessed. Identification of Sources of Evidence Health Promotion Model A health promotion model developed by Pender outlines some patient-specific factors that affect an individual’s behavior in relation to managing their health. For example, “perceived benefits of action, perceived barriers to action, perceived self-efficacy, activity-related affect, interpersonal influences, and situational influences” are the key elements to predict whether a patient will adhere to specific recommendations or not (Kurnia et al., 2017, p. 260). Innovation in Patient Education Another element of patient education is the use of innovational technology that allows better access to information and support from providers. Zand et al. (2018) explored the applicability of the Internet for the education of patients. While the current, most providers choose to help patients with diabetes using traditional education, which is a face to face meeting between a patient, nurse, and a physician, the Internet provides some substantial benefits. With the application of the Internet, the time and costs of such educational interventions can be significantly decreased. Findings from Articles Educational interventions are the main factor that providers can impact to improve the quality of life for patients with diabetes. According to Chatarjee et al. (2018), the danger of diabetes is the “long-term complications that can be prevented or delayed by intensive glycaemic management” (p. 130). Evidence suggests that patients with better self-management skills have better outcomes, and one way to address these skills is through education. The authors examined a large number of studies and concluded that there is significant variability in design and outcomes. Due to the fact that this research relies on secondary sources for data collection, studies will different time frames are reviewed because the main focus is on the nature of the intervention. Some of the researchers presented interventions that lasted from 1.5 to 25 months. The use of the PICOT framework allowed to structure the research problem and evidence collection.
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The Relevance of Findings from Articles A study by Kurnia et al. (2017) was selected because it tests the applicability of the health promotion model when designing interventions for patients with diabetes. The authors found that 20% of the variance in self-management can be explained by the patient’s self-efficacy, perceived benefits of educational interventions, and situational factors. The authors conclude that educational interventions for patients with diabetes should target the self-efficacy of individuals, as the enhancement of this quality leads to better outcomes. The rationale for selecting a study by Chaterjee et al. (2018) is the extensive evidence from other articles that the authors collected. This study is based on the examination of structured self-management education programs, which examined structured literature reviews of trials that focus on diabetes self-management education. The findings suggest that there is significant variability in terms of quality of these education programs, their duration, and access to them. In the study by Albanese-O’Neill et al. (2018), an eHealth application for an internet-based intervention was developed. The principal value of this research is the feedback from the participants regarding the use of this application. A study by Zand et al. (2018) was selected because of its focus on the value and benefits of internet-based interventions for diabetes patients. Conclusion Considering the modern healthcare disparities, there is a demand for an effective intervention that can be used to teach patients with diabetes how to manage their condition at home. The patient-centered model and health promotion models were applied to examine the educational interventions. The articles by Albanese-O’Neill et al. (2018), Chaterjee et al. (2018), Kurnia et al. (2017), and Zand et al. (2018) provide a cohesive explanation of the educational interventions and their effect, which helps explore the PICTO question. References Albanese-O’Neill, A., Schatz, D., Thomas, N., Bernhardt, J., Cook, C., & Haller, M. (2019). Designing Online and Mobile Diabetes Education for Fathers of Children With Type 1 Diabetes: Mixed Methods Study. JMIR Diabetes, 4(3), e13724. Web. Chatterjee, S., Davies, M., Heller, S., Speight, J., Snoek, F., & Khunti, K. (2018). Diabetes structured self-management education programmes: A narrative review and current innovations. The Lancet Diabetes & Endocrinology, 6(2), 130-142. Web. Kurnia, A., Amatayakul, A., & Karuncharernpanit, S. (2017). Predictors of diabetes self-management among type 2 diabetics in Indonesia: Application theory of the health promotion model. International Journal of Nursing Sciences, 4(3), 260-265. Web. Zand, A., Ibrahim, K., & Sadhu, A. (2018). Innovations in Professional Inpatient Diabetes Education. Current Diabetes Reports, 18(12). Web.
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