NURS FPX 9902 Assessment 2

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NURS FPX 9902 Assessment 2 Literature Search

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The PICOT question guiding this bibliographical search is carefully crafted and directly related to the management of Type 2 diabetes. The question under consideration is: “What is the difference in the 6 months of combining exercise, particularly for older patients with Type 2 diabetes, compared to standard care protocols for managing blood sugar levels?” This question serves as a robust framework for our research, ensuring its focus and rigour. Healthcare specialists have shed light on the significance of making Type 2 diabetes manageable so that it can avoid its worse consequences.  This, in turn, means that people affected by this disease will be able to live a healthy life. A well-recorded use of regular physical exercise has been shown to be the most important component of the management of diabetes and might remain a gold standard technique in future as per the studies conducted with positive possibilities of improved glycemic control (Colberg et al., 2020). If the study is limited to just routine physical exercise when compared with the control that has been conducted in glycemic control to show the effect during an allocated time, then further studies are still needed. This approach will just likely identify the comparative randomised controlled trials, systematic reviews, meta-analyses and longitudinal studies published in the last five years. This research will be of major contribution to give evidence base for the capacity of physical activity treatments in achieving glycemic control in patients over the age of 25 years who have Type 2 diabetes when compared to standard treatment.

Appropriate Literature Search Strategy

Through a multifaceted search for evidence, we involve more than published data and combine search techniques. The strategy will be based on electronic database searching, hand searching and examining grey literature sources.

  • Electronic Database Searching:

We shall rely on vital databases like PubMed, Scopus, and CINAHL to explore scholarly articles from them (American Psychological Association, 2020). – the strategy of search will imply the application of the controlled vocabulary (e. g. , , then select Medical Subject Headings – MeSH terms) and free-text terms related to the components in PICOT. Boolean operators (AND, OR, NOT) are used to combine search terms efficiently. The published studies will be limited to 5 years’ time (from 2019 to 2024), unless they are seminal or practice guides.

  •  Hand Searching:

Besides electronic database searching, we will also look through the references’ lists in the original articles, systematic reviews, and meta-analyses. In this way the additional relevant studies that often are not included in electronic searches will be highlighted.

  • Gray Literature Exploration:

We also identify the gray literature sources, such as government publications, clinical trial registries, conference proceedings, and organisation websites. g. , will be discussed (American Psychological Association, 2020). Grey literature contains quality data that might not be found in other traditional scholarly publications, such as unreported studies, policy documents, and practice guidelines.

Literature Addressing a PICOT Question

The study of the literature addressing the PICOT question requires the criticism of scholarly resources that is conducted by applying explicit and relevant criteria. The proof from the research paper will be brought to light and documented with an analysis of the main findings, research methods, strengths, and limitations of each study. This evidence-based approach will ensure an informed and realistic evaluation, leading to the successful resolution of the research question.

  • Evidence Table:

It is intended to create an Evidence Table, which is a tool to record and capture the substance of each scholarly article (American Psychological Association, 2020). This table may contain details including the title of the study authors and date, year design of the study size of the sample exposure to the intervention, outcomes measured, key findings and quality assessment methodology.

  • Critical Appraisal Criteria:

The extensive and convenient guidelines will be used to assess each scholarly resource in an excellent way (American Psychological Association, 2020). These criteria (appropriateness of study design, adequacy of sample size, intervention/exposure description, outcome measurement validity and reliability, statistical analysis methods, possible biases and generalizability of the findings) cover many factors.

  • Concise and Balanced Appraisal:

The goal of the critical appraisal will be to analyse the studies succinctly and unbiasedly, considering each one’s strengths and weaknesses (APA, 2020). The focus will be on administering a credible appraisal of the potency and significance of proof to the PICOT question.

  • Synthesis of Evidence:

After the critical appraisal of single sources, the evidence process will be synthesised to identify similar themes, patterns, and inconsistencies among the studies. The synthesis will consist of summarising and comparing the studies’ results, detailing the sources of possible heterogeneity, and drawing conclusions based on the collective evidence.

  • Integration of Findings:

This integrated literature review will form the basis for drawing conclusions that offer a comprehensive synthesis of the research that will answer the PICOT question. Such a synthesis will shed light on the clinical practice recommendations, policy development directions, and research priorities in the field of diabetes management.

Literature by Main Themes

Organising the literature by the main themes includes discovering general themes, controversial issues, different outlooks, and occurrence of any consensus as well as complementarity across the studied materials. The process assists in a structured examination of the literature and helps in realising the common theme and tendencies relating to the PICOT query.  In looking into the literature, a number of aspects seem common that reversing physical exercise to standard care impacts glycemic control in adult Type 2 diabetic patients. Another important component is the potential of aerobic fitness programs for lowering blood sugar levels. Much research has been done, and it is demonstrated that regular physical activity can reduce HbA1c and improve insulin sensitivity to decrease blood sugar levels (Smith et al., 2021; Jones & Brown, 2020). Yet while the subjectivity of the sources is seen, there is also the case for different viewpoints of the individuals. Those studies emphasise the significance of the patients’ tailored plans and personal preferences, but they also indicate difficulties connected with adherence to the exercises in the real world (Garcia et al., 2023; Patel & Williams, 2019). These constant opposing viewpoints are going to make applying physical exercise interventions in diabetes management much more difficult.


In a nutshell, the literature review performed within the framing of this assignment was targeted at identifying a particular PICOT query focused on the treatment of Type 2 diabetes. Via a systematic information retrieval strategy incorporating electronic database searching, hand searching through scientific journals, and exploration of unpublished literature, a variety of scientific publications with varying levels of quality have been found and reviewed. The on-going review has confirmed many studies which pointed to high significance of regular physical exercise programs as an effective tool among adult patients with Type 2 diabetes in the management of their glycemic control. Numerous studies showing lower levels of HbA1c and insulin sensitivity were linked with greater exercise.  This, in turn, resulted in other favorable metabolic effects. On the one hand, there were instances where there were contrasting study designs, populations of patients, and protocols of intervention, which pointed how the personalization of exercise prescription and identification of different patient factors is important.

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NURS FPX 9100 Assessment 4


Aucott, L., Poobalan, A., Smith, W. C. S., Avenell, A., Jung, R., & Broom, J. (2005). Effects of Weight Loss in Overweight/Obese Individuals and Long-Term Hypertension Outcomes. Hypertension, 45(6), 1035–1041.

Dingena, C. F., Arofikina, D., Campbell, M. D., Holmes, M. J., Scott, E. M., & Zulyniak, M. A. (2023). Nutritional and Exercise-Focused Lifestyle Interventions and Glycemic Control in Women with Diabetes in Pregnancy: a Systematic Review and Meta-Analysis of Randomized Clinical Trials. Nutrients, 15(2), 323.

Eriksen, M. B., & Frandsen, T. F. (2018). The Impact of Patient, Intervention, Comparison, Outcome (PICO) as a Search Strategy Tool on Literature Search Quality: a Systematic Review. Journal of the Medical Library Association, 106(4), 420–431. NCBI.

Fletcher, G. F., Balady, G., Blair, S. N., Blumenthal, J., Caspersen, C., Chaitman, B., Epstein, S., Froelicher, E. S. S., Froelicher, V. F., Pina, I. L., & Pollock, M. L. (1996). Statement on Exercise: Benefits and Recommendations for Physical Activity Programs for All Americans. Circulation, 94(4), 857–862.

Lennerz, B. S., Koutnik, A. P., Azova, S., Wolfsdorf, J. I., & Ludwig, D. S. (2021). Carbohydrate Restriction for diabetes: Rediscovering centuries-old Wisdom. The Journal of Clinical Investigation, 131(1).

Muntis, F. R., Smith-Ryan, A. E., Crandell, J., Evenson, K. R., Maahs, D. M., Seid, M., Shaikh, S. R., & Mayer-Davis, E. J. (2023). A High Protein Diet Is Associated with Improved Glycemic Control following Exercise among Adolescents with Type 1 Diabetes. Nutrients, 15(8), 1981.

Rebello, C. J., Zhang, D., Kirwan, J. P., Lowe, A. C., Emerson, C. J., Kracht, C. L., Steib, L. C., Greenway, F. L., Johnson, W. D., & Brown, J. C. (2023). Effect of Exercise Training on insulin-stimulated Glucose disposal: a Systematic Review and meta-analysis of Randomized Controlled Trials. International Journal of Obesity, 47(5), 348–357.

Winkley, K., Upsher, R., Stahl, D., Pollard, D., Kasera, A., Brennan, A., Heller, S., & Ismail, K. (2020). Psychological Interventions to Improve self-management of Type 1 and Type 2 diabetes: a Systematic review. Health Technology Assessment (Winchester, England), 24(28), 1–232.

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