PICOT Question Research Paper

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Post a clinically relevant research question using the PICOT format. How did you arrive at this topic and question? Why is it important?

Expectations:
-Read through the question, to ensure all questions asked were answered.
– At least three high-level scholarly peer-reviewed references in APA format from within the last 5 years.

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According to Sarker et al. (2022), the burden caused by type 2 diabetes mellitus causes significant concerns to healthcare systems hence requiring robust measures to ensure patients’ safety from complications of the condition including non-pharmacological strategies. Studies show that the knowledge and practice of a disease or condition significantly contribute to the overall outcomes of treatment (Le et al., 2021)PICOT Question Research Paper. With that said, some patients with type 2 diabetes develop complications due to inadequate information about the different aspects of self-management. My EBP change project proposal seeks to develop effective health education to improve outcomes of type 2 diabetes.

Population – adults with type 2 diabetes mellitus

Intervention – health education

Comparison – no health education

Outcome – glycaemic control and reduced complications of type 2 diabetes Time – three months

The picot question is: Among adults with diabetes mellitus (P), does health education (I), compared with no health education (C) result in glycaemic control and reduced complications of diabetes (O) within three months (T)?

I arrived at this question because of the need for improved care and reduced complications of diabetes reported at our primary care facility. Over the past four months, I have noticed that patients reporting to our unit have a higher understanding than in previous months. Within the four months, patients reporting for scheduled visits present with high blood glucose levels and glycated haemoglobin, four with neuropathy, retinopathy, and foot problems, which have been attributed to uncontrolled, type 2 DM. This statistic is unacceptable and requires immediate measures to curb it. Despite planning for frequent follow-up visits and counselling on adherence, our patients require extra measures to improve their outcomes. Chawla et al. (2019) highlight that effective health education helps improve glycaemic control, impedes the progression of DM and prevents subsequent complications. By this PICOT question, I propose implementing comprehensive health education on managing type 2 DM to promote self-management, glycaemic control and reduced complications.

The PICOT question will guide the search for relevant evidence from previously published literature. With the identification of supporting evidence, I will implement the intervention to help abate the burden of poor self-management of type 2 DM within our patient population PICOT Question Research Paper.

References

Chawla, S., Kaur, S., Bharti, A., Garg, R., Kaur, M., Soin, D., Ghosh, A., & Pal, R. (2019). Impact of health education on knowledge, attitude, practices and glycemic control in type 2 diabetes mellitus. Journal of family medicine and primary care, 8(1), 261–268. https://doi.org/10.4103/jfmpc.jfmpc_228_18

Le, N. K., Turnbull, N., Van Dam, C., Khiewkhern, S., & Thiabrithi, S. (2021). Impact of knowledge, attitude, and practices of Type 2 diabetic patients: A study in the locality in Vietnam. Journal of education and health promotion, 10, 72. https://doi.org/10.4103/jehp.jehp_712_20

Sarker, A., Das, R., Ether, S., Islam, M. S., & Saif-Ur-Rahman, K. M. (2022). Non-pharmacological interventions for the prevention of type 2 diabetes in low-income and middle-income countries: a systematic review of randomised controlled trials. BMJ open, 12(6), e062671. https://doi.org/10.1186/s13643-020-01550-z

PICOT Question

According to Sarker et al. (2022), the burden caused by type 2 diabetes mellitus causes significant concerns to healthcare systems hence requiring robust measures to ensure patients’ safety from complications of the condition, including non-pharmacological strategies. Studies show that the knowledge and practice of a disease or condition significantly contribute to the overall outcomes of treatment (Le et al., 2021)PICOT Question Research Paper. With that said, some patients with type 2 diabetes develop complications due to inadequate information about the different aspects of self-management. My EBP change project proposal seeks to develop effective health education to improve outcomes of type 2 diabetes.

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Population – adults with type 2 diabetes mellitus

Intervention – weekly self-management education sessions

Comparison – routine care (review of vital signs, weight, blood glucose, consulting clinician, collecting drugs, scheduling of subsequent appointments)

Outcome – glycemic control and reduced complications of type 2 diabetes

Time – three months

The PICOT question is: Among adults with type 2 diabetes mellitus (P), does weekly self-management education (I), compared with routine care (C), result in improved self-care, glycemic control, and reduced complications (O) within three months (T)?

I arrived at this question because of the need for improved care and reduced complications of diabetes reported at our primary care facility. Over the past four months, I have noticed that patients reporting to our unit have a higher understanding than in previous months. Within the four months, patients reporting for scheduled visits present with high blood glucose levels and glycated hemoglobin, four with neuropathy, retinopathy, and foot problems, which have been attributed to uncontrolled, type 2 DM. This statistic is unacceptable and requires immediate measures to curb it. Despite planning for frequent follow-up visits and counseling on adherence, our patients require extra measures to improve their outcomes. Hailu et al. (2019) highlight that weekly education on diabetic self-management and self-efficacy, compared to usual care, improved the participants’ knowledge about diabetes, increased self-care, enhanced adherence to recommendations, and prevented complications. Routine care includes reviewing vital signs, weight, and blood glucose, consulting clinicians, collecting drugs, and scheduling subsequent appointments. By this PICOT question, I propose implementing comprehensive self-management education on managing type 2 DM to promote self-care, self-efficacy, and glycaemic control and reduce complications. PICOT Question Research Paper

The PICOT question will guide the search for relevant evidence from published literature. With the identification of supporting evidence, I will implement weekly health education to help abate the burden of poor self-management of type 2 DM within our patient population. Weekly educational sessions will occur during scheduled visits to facilitate close monitoring of learning and outcomes.

References

Hailu, F. B., Moen, A., & Hjortdahl, P. (2019). Diabetes self-management education (DSME)–Effect on knowledge, self-care behavior, and self-efficacy among type 2 diabetes patients in Ethiopia: A controlled clinical trial. Diabetes, metabolic syndrome and obesity: targets and therapy, 12, 2489. https://doi.org/10.2147/DMSO.S223123 PICOT Question Research Paper

Personal Theory

Type 2 diabetes mellitus is one of the significant and prevalent lifestyle diseases. The disease is defined by constantly elevated serum glucose caused by defective insulin secretion and insulin resistance (Galicia-Garcia et al., 2020)PICOT Question Research Paper. As stipulated by Khan et al. (2020), type 2 diabetes mellitus affects approximately 6.28% of the world’s population. It is responsible for approximately 1 million deaths annually. Patients with diabetes are susceptible to acute and chronic complications. Most of these complications are life-threatening if not addressed urgently. These complications are also responsible for most hospital admissions. Besides the medical management of these complications, for curative and preventative purposes, other non-pharmacological interventions are used.

The writer’s proposed theory is related to the non-pharmacological approach to preventing diabetes complications. Comprehensive diabetes education (concept A) reduces (proposition) the incidence of diabetes complications and hospital admissions (concept B). According to Le et al. (2021), most diabetic patients are unaware of diabetes complications and the measures to prevent them. Lack of knowledge contributes to poor self-management, poor disease outcomes, frequent hospitalizations, and readmissions because of complications. However, patient education with knowledge about diet, exercise, and compliance to treatment can reduce the risk of complications. Appropriate health education improves patient knowledge about the disease, attitudes, and practices leading to improved glycaemic control and prevention of complications (Chawla et al., 2019)PICOT Question Research Paper.

In an interventional study conducted by Mokabel et al. (2017), patients were enrolled in a diabetic educational program to assess its efficacy in managing type 2 diabetes mellitus. The study’s findings showed that the patients exposed to the educational program had positive outcomes such as reducing body mass index, improved serum glucose monitoring, dietary regimen, exercise, and behavior. They also reduce the need for hospitalization. Therefore, it is a recommended evidence-based approach to optimizing care for diabetes outcomes PICOT Question Research Paper.

References

Chawla, S., Kaur, S., Bharti, A., Garg, R., Kaur, M., Soin, D., Ghosh, A., & Pal, R. (2019). Impact of health education on knowledge, attitude, practices, and glycemic control in type 2 diabetes mellitus. Journal of family medicine and primary care, 8(1), 261–268. https://doi.org/10.4103/jfmpc.jfmpc_228_18

Galicia-Garcia, U., Benito-Vicente, A., Jebari, S., Larrea-Sebal, A., Siddiqi, H., Uribe, K. B., Ostolaza, H., & Martín, C. (2020). Pathophysiology of Type 2 Diabetes Mellitus. International journal of molecular sciences, 21(17), 6275. https://doi.org/10.3390/ijms21176275

Khan, M., Hashim, M. J., King, J. K., Govender, R. D., Mustafa, H., & Al Kaabi, J. (2020). Epidemiology of Type 2 Diabetes – Global Burden of Disease and Forecasted Trends. Journal of epidemiology and global health, 10(1), 107–111. https://doi.org/10.2991/jegh.k.191028.001

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Mokabel, F. M., Aboulazm, S. F., Hassan, H. E., Al-Qahtani, M. F., Alrashedi, S. F., & Zainuddin, F. A. (2017). The efficacy of a diabetic educational program and predictors of compliance of patients with noninsulin-dependent (type 2) diabetes mellitus in Al-Khobar, Saudi Arabia. Journal of family & community medicine, 24(3), 164–172. https://doi.org/10.4103/jfcm.JFCM_45_16 PICOT Question Research Paper

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