Submit PICO(T) Question

Submit your PICO(T) clinical question. See grading rubric in Syllabus Supplement and sample PICOT for guidance.

PICOT/The Research Question 

The student will reflect on clinical nursing practice and write a research question. The question will be developed by using the PICOT framework (Population, Intervention, Comparison, Outcome, Time). The student will identify a nursing clinical question as follows:

·        What individual or group am I curious about? (population)

·        What key intervention am I curious about? (intervention) 

·        What intervention will I be comparing? (comparison) 

·        What do I hope to accomplish, or What would happen if I did this? (outcome)

·        How much time will the intervention take to achieve the desired effects? (time)

The aim of the PICOT is to discover current research and promote best practices. The PICOT will guide the Literature Review. The PICOT must have a nursing clinical focus. A rationale for each element of the PICOT question must be provided and supported by a credible source. List the references on the reference page, following APA format.

Students will be able to resubmit the PICOT assignment one time.

PICOT/Research Question

In adults 65 years and older diagnosed with diabetes mellitus, how effective are the use of

dietary supplements, such as cinnamon, compared to medication alone, such as insulin

therapy/oral hypoglycemics, in the prevention of diabetic complications within a one-year

period?

PICOT TABLE

P Adults 65 years and older diagnosed with diabetes mellitus

Age is one of the most important risk factors for type 2 diabetes with

individuals in older age groups assuming a high burden of disease. Selvin

and Parrinello (2013) stated that in the US, adults aged 65 or older had 20%

prevalence of diabetes in 2011 versus the 2.4% disease prevalence found

among adults 18 to 44 years of age.

I Dietary supplements like cinnamon

It is believed that dietary supplements like cinnamon help patients to control

blood glucose. Hasanzade et al. (2013) stated that traditional herbs and

spices such as Ròu Guì and Cinnamomum cassia are commonly used for

control of glucose. They also stated that cinnamon was the most bioactive

among spices such as mint, green tea, and carnation.

Commented [RC1]: Where is the title page?

Commented [RC2]: Page numbers are missing!

Commented [RC3]: Each element is identified from the
PICOT question

Commented [RC4]: Each element is supported by a
reference.

Commented [RC5]: Good use of APA format!
You don’t need to use a different reference each time, but

each section should be supported with a reference

C Insulin/Oral hypoglycemic medications

Insulin and/or oral glycemic medications are universally used to treat and

manage diabetes due to their ability to control blood sugar levels. Insulin

offers a unique ability to control hyperglycemia when used from the time of

diagnosis and when metabolic control is disturbed by medical illness,

procedures, or therapy, as well as in the longer term (Home et al., 2014).

O Prevention of diabetic complications

The ultimate goal of diabetes management is prevention of long-term

complications. Uncontrolled diabetes can lead to a number of short and

long-term health complications, including hypoglycemia, heart disease,

nerve damage, limb amputation, and vision problems. According to Vinik &

Vinik (2003), chronic complications can be devastating to patients with

diabetes mellitus. The major cause of morbidity and mortality among these

patients are complications such as cardiovascular illness, macrovascular

disease, and microvascular disease, with retinopathy, nephropathy, and

neuropathy.

T Within a one-year period

There is no set time frame for diabetic complications to occur. It all

depends on how uncontrolled the management has been. The duration of

diabetes and the degree of glycemic control achieved are noted to be risk

factors for complications (Nickerson & Dutta, 2012).

References

Hasanzade, F., Toliat, M., Emami, S. A., & Emamimoghaadam, Z. (2013). The effect of

cinnamon on glucose of Type II diabetes patients. Journal of Traditional and

Complementary Medicine, 3(3), 171–174. https://doi.org/10.4103/2225-4110.114900

Home, P., Riddle, M., Cefalu, W. T., Bailey, C. J., Bretzel, R. G., Del Prato, S., Leroith, D.,

Schernthaner, G., van Gaal, L., & Raz, I. (2014). Insulin therapy in people with type 2

diabetes: Opportunities and challenges? Diabetes Care, 37(6), 1499–1508.

https://doi.org/10.2337/dc13- 2743

Nickerson, H. D., & Dutta, S. (2012). Diabetic complications: Current challenges

and opportunities. Journal of Cardiovascular Translational Research, 5(4),

375–379. https://doi.org/10.1007/s12265-012-9388-1

Selvin, E., & Parrinello, C. M. (2013). Age-related differences in glycemic control in diabetes.

Diabetologia, 56(12), 2549–2551. https://doi.org/10.1007/s00125-013-3078-7

Vinik, A. I., & Vinik, E. (2003). Prevention of the complications of diabetes. The American

Journal of Managed Care, 9(3 Suppl), S63–S84.

Commented [RC6]: The reference page starts on a new
page.

Commented [RC7]: References placed in alphabetical
order

Commented [RC8]: References follow APA 7e format

PICOT Question:

A patient of age 40 years is diagnosed with some lung problems and admitted to hospital. How effective will be the strategy of cessation of smoking for the period of two months to overcome the lung problems as compared to chemotherapy and inhalers.

P

Patient with age of 4o years admitted to hospital.

According to the American Cancer Society, roughly 235,760 new cases of lung cancer are diagnosed each year, with males accounting for 119,100 new cases and women accounting for 116,660 new cases. Furthermore, lung cancer claims the lives of approximately 131,880 people, with 69,410 men and 62,470 women (Lung Cancer Statistics, n.d.). According to the American Cancer Society’s study, lung cancer is by far the most common cause of cancer mortality, accounting for 25% of all cancer fatalities (Lunger Cancer Statistics, n.d.). Lung cancer is a long-term illness that involves the development of malignant cells in the lungs.

I

Cessation of smoking.

Continuous research and technological developments have enabled researchers to conduct investigations that have led to clinical trials. Many research and clinical trials have been conducted in order to determine the most prevalent cause of lung cancer in patients, as well as the success of smoking cessation. According to one research, there is a compelling case for delivering smoking cessation therapies to patients who smoke and are being screened for lung cancer (Joseph. A, 2018). Not to add that successful smoking cessation programmes may help to lower cancer and cardiovascular disease mortality and morbidity rates (Joseph. A, 2018). Another research found that smoking increases the risk of lung cancer and other lung problems (Lederer. D, 2009).

C

Chemotherapy and Inhalers

Though smoking cessation therapies have been shown to improve quality of life and reduce the morbidity and death rates associated with lung cancer, it is important to remember that such interventions are prohibitively costly. However, evidence shows that a smoking cessation intervention enhances ACERS, making its inclusion in any screening program a strong recommendation (Goffin. J, 2016).

O

Prevention of complications due to smoking

In a clinical examination of smokers in NSLT, 70 percent pondered quitting, 13 percent were ready to stop, and 13 percent had no intention of quitting, according to research (Joseph. A, 2018). While participating in the New York Early Cancer Action Project, 32% were serious about stopping in 30 days and 47% were thinking about quitting in six months (Joseph. A, 2018). The American Thoracic Society and the American College of Chest Physicians have issued a set of guidelines to help build successful lung cancer screening methods in terms of personnel and preparation for smoking cessation interventions (Joseph. A, 2018). On-site clinical professionals, as well as radiologists, are used to conduct smoking cessation therapy. On-site personnel, on the other hand, vary in terms of training and comfort in administering smoking cessation therapy (Joseph. A, 2018).

T

Two months period

Smoking cessation therapies are administered via psychological and behavioural approaches, with the former requiring no medication and the latter requiring it. Nurses are crucial in influencing a patient’s desire to stop smoking. Nurses serve as a connection between the patient and the smoking cessation intervention because they are encouraged to speak with their patients about quitting smoking. Furthermore, they must be appropriately trained in order to give patients with viable choices as well as enrolling them in the right smoking cessation programme (Carlebach. S, 2009). Overall, nurses are or should be motivated by the desire to help their patients improve and maintain their health habits, as well as the urge to engage in preventive care. Smoking cessation nurses will be able to integrate evidence-based strategies in their practises, improving patient health and lowering lung cancer-related mortality.

References

Lung Cancer Statistics: How Common is Lung Cancer? American Cancer Society. (n.d.). https://www.cancer.org/cancer/lung-cancer/about/key-statistics.html#:~:text=Lung

Nakao, K. (2012). Smoking history and underlying lung disease are associated with poor outcome in patients developing interstitial pneumonia during low-dose amiodarone therapy. Journal of Arrhythmia, 29(1), 5–8. https://doi.org/10.1016/j.joa.2012.04.005

Joseph, A., Rothman, A., Almirall, D., Begnaud, A., Chiles, C., Cinciripini, P., Fu, S., Graham, A., Lindgren, B., Melzer, A., Ostroff, J., Seaman, E., Taylor, K., Toll, B., Zeliadt, S., & Vock, D. (2018). Lung Cancer Screening and Smoking Cessation Clinical Trials SCALE (Smoking Cessation within the Context of Lung Cancer Screening) Collaboration. American Journal of Respiratory and Critical Care Medicine, 197(2), 172– 182. https://doi.org/10.1164/rccm.201705-0909CI

Lederer, D., Enright, P., Kawut, S., Hoffman, E., Hunninghake, G., van Beek, E., Austin, J., Jiang, R., Lovasi, G., & Barr, R. (2009). Cigarette Smoking Is Associated with Subclinical Parenchymal Lung Disease: The Multi-Ethnic Study of Atherosclerosis (MESA)-Lung Study. American Journal of Respiratory and Critical Care Medicine, 180(5), 407–414. https://doi.org/10.1164/rccm.200812-1966OC

Goffin, J., Flanagan, W., Miller, A., Fitzgerald, N., Memon, S., Wolfson, M., & Evans, W. (2016). Biennial lung cancer screening in Canada with smoking cessation—outcomes and cost-effectiveness. Lung Cancer (Amsterdam, Netherlands), 101, 98–103. https://doi.org/10.1016/j.lungcan.2016.09.013

Carlebach, S., & Hamilton, S. (2009). Understanding the nurse’s role in smoking cessation. British Journal of Nursing, 18(11), 672-676.