Student’s Name
Capella University
NURS-FPX4030: Making Evidence-Based Decisions
February 2023
PICO (T) Questions and an Evidence-Based Approach
A PICOT question enables nurse researchers to make informed decisions about evidence-based interventions appropriate for improving the quality and safety of patient care. A comprehensive question detailing an intervention and alternative option allows researchers to synthesize credible and reliable evidence on efforts necessary to optimize care outcomes. Red Yoder’s scenario (Boese, 2022) guides nurse researchers to understand the patient’s situation and design a PICOT question on effective means of improving health and quality of life. Evidence from peer-reviewed articles provides insights into the need for effective strategies among them diabetes self-management to encourage Yoder to take charge of his health and well-being. The PICOT question appropriate for Yoder’s situation would be; for Yoder’s diabetes complications (P) will self-care practices (I) compared to medications (C) reduce insulin dependence (O) within three months (T)? The question highlights the need for enhanced health promotion and education to make Yoder aware of personalized efforts necessary to monitor and manage symptoms. This way, successful outcomes will depend on the patient’s commitment to practicing self-care including, proper foot hygiene, exercise, and adherence to recommended medications to overcome the difficulties of living an insulin dependent lifestyle.
Addressing Yoder’s Condition
Yoder’s situation highlights the need for a comprehensive plan. The tailored intervention makes Yoder familiar with lapses in current disease management and the need to take charge of his health and well-being. Yoder’s insulin dependence life, poor foot care, inconsistent sleeping patterns, and others increase the cost of care. Diabetes self-management is a viable and cost-effective alternative meant to strengthen the patient’s ability to monitor and manage symptoms. The intervention reminds Yoder about his roles and obligation towards improving the quality, safety, and cost of care. For instance, the patient will access information on the right diet, medications, alcohol moderation, exercise, and self-monitoring of blood glucose levels. Similarly, Yoder will embrace effective foot hygiene to prevent diabetes exacerbations.
The Recommended Intervention
The intervention identified is diabetes self-management. The practice means empowering patients to make informed choices and decisions about managing their life and diabetes symptoms. Excellent self-management helps improve quality of life and reduce the risk of developing complications and premature deaths. In this case, Yoder gets the chance to make the right food choices, manage weight, exercise, and adhere to recommended medications. A key concern from the medical consultation is the need for effective foot care characterized by thorough washing, right shoe selection, performing daily foot exam, and checking out for objects that may irritate feet. As such, foot care reminds patients living with diabetes about their roles in adhering to standards on effective symptoms management. Adequate patient engagement is necessary to make Yoder aware of tailored strategies that match demographic profile and other personal aspects.
Evidence from peer-reviewed journal articles describe diabetes self-management as a viable and sustainable option for improving the quality, safety, and cost of patient care. Elkady (2020) encouraged patients to embrace self-management to overcome emotional distress and achieve self-efficacy necessary for improving health-related quality of life. Hirpha et al. (2020) described diabetes foot self-care practices as an essential consideration for patients aiming to reduce costs and risk of diabetes exacerbations. Qi et al. (2021) and Sidiq et al. (2021) also shared insights into self-management behavior appropriate for improving quality of life for patients above 60 years. The fifth source is by Türkmen et al. (2020) and acknowledged the need for increased knowledge and positive attitudes among patients with diabetic foot ulcer to enable them embrace effective foot care. The articles meet the criteria established by Currency, Relevance, Authority, Accuracy, and Purpose (CRAAP). The sources are current publications produced within the last four years by authors with reputable credentials and organizational affiliation. Similarly, objective tone and findings based on evidence make the sources for producing a research paper. Further, the authors focus on diabetes self-management and, which match the PICOT question and empowers Yoder to take charge of his health and well-being.
Relevant Findings
The five sources identified for this paper provide credible and reliable evidence on diabetes self-management and implications on quality of life. Elkady (2020) linked self-management with emotional well-being and self-efficacy that make patients resilient in monitoring and managing symptoms. Hirpha et al. (2020) also associated self-management with reduced risk of diabetes exacerbations. Patients embrace lifestyles, foot hygiene, and other practices that make them responsive to calls for tailored strategies for managing symptoms. Similarly, Qi et al. (2021) and Sidiq et al. (2021) focused on the need for positive health-seeking behaviors and attitudes among patients living with diabetes. The aim is to encourage individuals to make informed decisions about self-care practices necessary for optimizing care outcomes. Findings by Türkmen et al. (2020) also encourage Yoder to understand diabetes self-management including proper foot care to overcome the risk of exacerbations caused by the open wound.
The most useful sources are by Türkmen et al. (2020) and Hirpha et al. (2020). The two focus on foot care for patients living with diabetes, which is among the serious issues facing Yoder. This way, the findings inform patients about the need for thorough washing of feet, the right shoe selection, and hygiene to avoid complications triggered by an open and unattended foot wound.
Conclusion
A PICOT guides nurse researchers to synthesize evidence from credible and reliable sources. Yoder’s scenario provides insights into the need for healthcare professionals to identify and intervention that help improve quality, safety, and cost of patient care. In this case, diabetes self-management is a viable and sustainable option for Yoder to monitor and manage symptoms and prevent exacerbations.
References
Boese, T. (2022). Red Yoder. National League for Nursing. https://www.nln.org/education/teaching-resources/professional-development-programsteaching-resourcesace-all/ace-s/unfolding-cases/red-yoder-6121c65c-7836-6c70-9642-ff00005f0421
Elkady, A. A. (2020). Self-care management, emotional distress and self-efficacy: Relationships with health-related quality of life among patients with type 2 diabetes. International Journal of Psycho-Educational Sciences, 8(2), 73-84. https://files.eric.ed.gov/fulltext/EJ1250728.pdf
Hirpha, N., Tatiparthi, R., & Mulugeta, T. (2020). Diabetic foot self-care practices among adult diabetic patients: A descriptive cross-sectional study. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 13, 4779-4786. doi: 10.2147/DMSO.S285929
Qi, X., Chen, G., Liu, H., Liu, J., Wang, J., Zhang, X., Hao, Y., Wu, Q., & Jiao, M. (2021). Self-management behavior and fasting plasma glucose control in patients with type 2 diabetes mellitus over 60 years old: Multiple effects of social support on quality of life. Health and Quality of Life Outcomes, 19(254), 1-14. https://hqlo.biomedcentral.com/articles/10.1186/s12955-021-01881-y
Sidiq, R., Silaban, E., Handayani, M., & Liana, I. (2021). Acceptance of diabetes patients to self-management educational media among middle age and older adults: Self-Management educational media among older adults with diabetes. International Journal of Aging Health and Movement, 3(2), 1-12. http://ijahm.com/index.php/IJAHM/article/view/24/17
Türkmen, A., Seyhan, E., & Özbaş, A. (2020). Research of knowledge and attitudes of patients with diabetic foot ulcer regarding foot care. International Journal of Diabetes and Clinical Research, 8(144), 1-7. doi: 10.23937/2377-3634/1410144