PICOT Statement and Research Critiques Paper

PICOT Statement and Research Critiques Paper

Assignment Benchmark - Research Critiques and PICOT Statement Final Draft

Details:

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the Topic 1, 2, and 3 assignments and the guidelines below.

PICOT Statement

Revise the PICOT statement you wrote in the Topic 1 assignment.

The final PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments you completed a qualitative and quantitative research critique. Use the feedback you received from your instructor on these assignments to finalize the critical analysis of the study by making appropriate revisions.PICOT Statement and Research Critiques Paper

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT statement.

Refer to "Research Critique Guidelines." Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT statement, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.PICOT Statement and Research Critiques Paper

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Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

Quantitative Study

Churchill M , et al. (n.d.).  - PubMed - NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/10218187. Using a therapy dog to alleviate the agitation and desocialization of people with Alzheimer's disease. A Matched Case–Control Trial.PICOT Statement and Research Critiques Paper

Background of Study

According to the The Alzheimer's Association there has been an  estimated number of  4 million individuals suffer from Alzheimer’s Disease, also known as AD, and by 2050, this static  will continue to grow to an estimated 14 million (Alzheimer's Association, 1998).  These figures are an indication that the care for those affected by AD will place a burden on health resources with the burden only expected to grow over time.  To counter the expected burden, it is projected that medical care should be focused on addressing the neuropsychiatric symptoms that include anxiety, apathy, depression, and agitation. These symptoms are chronically present in all patients and only worsen over time. Previously, psychotropic medication was used to address these symptoms. Nonetheless, evaluations show that these medication have little effect on the symptoms, and no effect on the quality of life often times resulting in the patient being lethargic along with little interaction in life and or family members at all.   AD is a neurological disorder that presents as a slow, progressive disorder that over time will lead the individual to experience a decrease in cognitive function exacerbated by impairments in memory, reasoning, abstraction, and personality (Manor, 1991). Based on this awareness, pet therapy along with other alternative methods, such as music therapy is proposed as a psychosocial intervention that could achieve the desired goal of addressing the neuropsychiatric symptoms of AD and dementia while improving the quality of life PICOT Statement and Research Critiques Paper. As such, the present study evaluates usefulness of proposed therapies as mentioned to show improved patient outcomes as well as quality of life.  Even though it has been considered that  AD is a disease that affects only the elderly, it has been diagnosed in younger people (Alzheimer's Association, 1998).  The cause of AD, even in today’s time with advanced technology is still unknown.  Secondary to the effect of this disease on the normal brain activity can often times result in the patient experiencing late afternoon symptoms, referred to as Sundowners. Behavioral changes that are associated with sundown syndrome include restlessness and verbal behavior (Evans, 1987); confusion; aimless wandering; paranoia; agitation; and aggressive behavior, such as hitting, kicking, and biting directed toward staff, family, or other patients that will take place during evening hours. Agitated patients often display symptoms such as uncooperative routines, that results in difficulties for the staff caring for the patient. The tendencies of these aggressive behaviors may lead the patient to have feelings of seclusion, loneliness, and fear, resulting in increased aggressive behaviors.PICOT Statement and Research Critiques Paper

Methods of Study

An experimental and repeated measure design utilized that was used for this study. The subjects were recorded under two random ordered conditions both with and without the dog present, being aware that this research project was approved through the Institutional Review Board and the Institutional Animal Care and Use Committee. Eligibility to be involved in the study included a diagnosis of AD or a related disorder such as Dementia, residence in a special-care unit, display of agitated behavior in the evening hours, no allergies to dogs or bad experiences with them, consent from the legally authorized representative person/persons.PICOT Statement and Research Critiques Paper

There were three extended care facilities with special-care units in the Midwest that consisted of individuals with AD or a related disorder. Each of these facilities held 20 to 35 residents on the unit, and each unit had a common area (lounge) where residents congregated for the day. Those studied consisted of twenty-eight individuals to include 21 women, 7 men.  Each of those involved in the study were also noted to be caucasian with a mean age of 83 and older, all with different levels of severity of the disease.PICOT Statement and Research Critiques Paper

Results of Study

The presence of the therapy dog showed nothing less than encouraging results that included verbalizations, smiles, looks, leans, and tactile contact. The importance of looks and smiles could be considered as an indication of happiness and interest, as well as the importance of touch displaying a nonverbal approach to communication. When considering this aspect, one must consider the importance of touch even in those that do not suffer from a disease.  Companionship, touch, and the feelings of affection is necessary in all elements of physical and mental health regardless of age, race, gender, or even those suffering from disease.PICOT Statement and Research Critiques Paper

Ethical Considerations

The study mentions that ethical approval for the research was sought from all affiliated institutions after extensive consultation throughout the research process.  The approval was based upon that the study showed no harm to those that were involved in the study and adequate actions had been undertaken to ensure that the participants as well as the animals were protected. In addition, it mentions that there was a requirement for informed consent that was signed by the participants to show that they were aware of the research intentions and consented to participate.PICOT Statement and Research Critiques Paper

Conclusion

There is much to be learned about the best treatment for those that suffer from such a sad and deteriorating disease known as Alzheimer’s and Dementia especially knowing that there is rarely early detection and no know cure.  Family members are often times found to be at a loss and only searching for ways to bring their loved ones back to who they used to be.  Even in our worse state, it is simply amazing how a simple thing such as touch, feelings of love and security can make all the difference in the world to a bad day.  This study showed that the presence of a therapy dog did improve socialization and decreased agitation in persons with AD or a related disorder during sundown hours. These changes, however, were found to be unrelated to the severity of the disease process.  With this being said, the results are valuable to nursing practitioners since they show a clear correlation between those that suffer from AD and dementia and that with the use of pet and other alternative methods such as music therapy are under review so that nurses will have evidence to support proposals for development of pet, music and possible other therapy programs .PICOT Statement and Research Critiques Paper