PICOT Question And Literature Search

PICOT Question And Literature Search

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Summary of Clinical Issue: Diabetes can be a debilitating chronic disease if not effectively managed. Due to age, lifestyle, and vulnerability, among other issues, the elderly are among the highly affected populations with diabetes. The United States, China, and India lead in countries with the largest proportion of the elderly with diabetes (Sinclair et al., 2020). Due to the far-reaching effects of diabetes, including heart problems, effective management is vital, and patients should be closely monitored. Effective diabetes management necessitates a continuous collaboration between patients and health care providers. Health information technology tools such as patient portals play an integral role in promoting engagement, supporting patient-provider communication, and enhance clinical outcomes in managing diabetes (Portz et al., 2019). However, their use among the elderly population has not reached the desired levels.

Several studies have explored the challenges leading to the underutilization of patient portals to enhance diabetes management among the elderly. Portz et al. (2019) found that the level of technology literacy among the elderly is low, discouraging them from using patient portals maximally. Nahm et al. (2018) added that issues to do with perceived benefits and practical difficulties with managing patient portals are typical barriers to using patient portals. Accordingly, practical interventions are necessary to address fears associated with patient portals, change perception, and improve literacy. In health practice, patient education is used to impart information to patients to alter their behaviors. The same approach can improve literacy among the elderly to make them better users of patient portals.

PICOT Question: In older adults with diabetes (P), can education on using patient portals (I) compared to no patient education (C) improve patient-provider engagement (O) in three months (T)?

Criteria	Article 1	Article 2	Article 3
APA-Formatted Article Citation with Permalink	Portz, J. D., Bayliss, E. A., Bull, S., Boxer, R. S., Bekelman, D. B., Gleason, K., & Czaja, S. (2019). Using the technology acceptance model to explore user experience, intent to use, and use behavior of a patient portal among older adults with multiple chronic conditions: Descriptive qualitative study. Journal of Medical Internet Research, 21(4), e11604. Doi: 10.2196/11604	Sieck, C. J., Hefner, J. L., & McAlearney, A. S. (2018). Improving the patient experience through patient portals: Insights from experienced portal users. Patient Experience Journal, 5(3), 47-54. doi: https://doi.org/10.35680/2372-0247.1269	Nahm, E. S., Zhu, S., Bellantoni, M., Keldsen, L., Charters, K., Russomanno, V., … & Smith, L. (2020). Patient portal use among older adults: What is really happening nationwide?. Journal of Applied Gerontology, 39(4), 442-450. https://doi.org/10.1177%2F0733464818776125
How Does the Article Relate to the PICOT Question?	It examines challenges hindering the use of patient portals among the elderly and how to enhancing literacy can improve clinical outcomes.	It expands knowledge on portals use as tools for improving collaboration and engagement in self-care for patients with chronic illnesses.	The article examines experiences, challenges, and suggestions to improve patient portals’ use among the elderly population to improve illness management.
Quantitative, Qualitative (How do you know?)	Qualitative (it is a qualitative descriptive study)	Qualitative study (uses interviews to collect data).	Quantitative. It uses the randomized controlled trials
Purpose Statement	The study examines how portal user interface and user experience preferences of older adults with multiple chronic illnesses may improve usage.	The study’s primary aim is to learn perspectives on portal use among experienced users and their effect on collaboration and engagement.	The aim of the study was to explore older adults’ experiences using patient portals, perceived impacts on their health, and strategies for improvement.
Research Question	Can patient portals’ user experience affect their use among elderly patients with chronic illnesses?	Which elements motivate patients to use patient portals to manage care and improve relationships with providers?	How does experience and perceived impact of patient portals on older adults’ health affect their use among the elderly population?
Outcome	User experience and user interface affect adoption of patient portals among the elderly.	A high sense of collaboration and greater trust in the relationship improve patients use patient portals.	Reduced challenges in using patient portals increases their use among older adults in chronic illness management.
Setting (Where did the study take place?)	Denver metro area	A large Midwestern Academic Medical Center (AMC)	29 states in the United States
Sample	24 older patients with multiple chronic illnesses	29 patients	272 older adults (English speaking)
Method	Stratified random sampling and semi-structured focus groups were used.	Qualitative study involving 29 semi-structured interviews.	Randomized controlled trials
Key Findings of the Study	Patient portals design and log-ins challenges inhibit participants’ intent to use patient portals.	A sense of collaboration with their providers and greater trust in the relationship makes patients better users of patient portals.	Older adults like to use patient portals but experience to use is a significant barrier.
Recommendations of the Researcher	Health literacy among patients should be improved to address challenges related to interface, designs, and log-ins.	Patients should be helped to understand how to use patient portals effectively to increase their engagement and improve experience.	The needs for older adults should be considered when implementing health IT programs in health care facilities.

Criteria	Article 4	Article 5	Article 6
APA-Formatted Article Citation with Permalink	Edmonds, S., Lou, Y., Robinson, B., Cram, P., Roblin, D. W., Wright, N. C., … & Wolinsky, F. D. (2019). Characteristics of older adults using patient web portals to view their DXA results. BMC Medical Informatics and Decision Making, 19(1), 1-10. doi: 10.1186/s12911-019-0904-y	Kim, S., & Fadem, S. (2018). Communication matters: Exploring older adults’ current use of patient portals. International Journal of Medical Informatics, 120, 126-136. https://doi.org/10.1016/j.ijmedinf.2018.10.004	Irizarry, T., Shoemake, J., Nilsen, M. L., Czaja, S., Beach, S., & DeVito Dabbs, A. (2017). Patient portals as a tool for health care engagement: A mixed-method study of older adults with varying levels of health literacy and prior patient portal use. Journal of medical Internet research, 19(3), e99. https://doi.org/10.2196/jmir.7099
How Does the Article Relate to the PICOT Question?	It expands knowledge on the challenges hampering the use of patient portals in illness management among older adults.	The study confirms that patient portals can increase patient engagement among older adults but perception issues hamper their use.	It examines how literacy levels affect the use of patient portals among older adults.
Quantitative, Qualitative (How do you know?)	Qualitative (patients are interviewed during a secondary analysis of data)	Quantitative (uses surveys to collect data)	Quantitative (uses surveys to collect data)
Purpose Statement	The study seeks to identify patient characteristics associated with the use of patient web portals to view test results.	The study explores attitudes toward, perceived utility of, and requirements of a patient portal from older adults’ perspective.	The study explores attitudes and perceived usefulness of patient portals in health care engagement among older adults with varying health literacy.
Research Question	What are the patient characteristics affecting the use of web portals?	Can changing older adults’ perception of patient portals increase their use among older adults?	Do health literacy levels and experience navigating patient portals affect their adoption?
Outcome	Availability of web portals is not adequate to promote patient-provider engagement and checking test results.	Older adults will increase the use of patient portals in illness management if they deem them useful.	Differences in health literacy affect older adults’ patient-provider engagement.
Setting (Where did the study take place?)	University of Iowa and Kaiser Permanente of Georgia.	New Jersey metropolitan region of the United States.	A community-based study (open) in the United States.
Sample	4669 patients	Survey- 70 participants Participatory design workshops- 17 participants	100 community dwelling older adults
Method	Interviews during enrollment and 12 weeks later.	Mixed-methods approach consisting of online surveys, a review of existing portals, and participatory design studies.	Phone survey data collection.
Key Findings of the Study	Patients need awareness on the need to use web portals and helped to understand their usage regardless of age and literacy levels.	Older adults usually use patient portals for interacting with health care providers and not for accessing and managing health information.	Differences in health literacy and comfort navigating health information on the web affect adoption of patient portals among older adults.
Recommendations of the Researcher	Health care organizations should continuously explore the challenges facing older and less educated when it comes to health information access via web portals.	Health care providers should show the willingness to interact with older adults to change their (older adults) perception about the importance of patient portals in engagement and health management.	Increasing health literacy and navigation skills among older adults are vital to improving their skills and encouraging using patient portals in illness management.

References

Edmonds, S., Lou, Y., Robinson, B., Cram, P., Roblin, D. W., Wright, N. C., … & Wolinsky, F. D. (2019). Characteristics of older adults using patient web portals to view their DXA results. BMC Medical Informatics and Decision Making, 19(1), 1-10. doi: 10.1186/s12911-019-0904-y

Irizarry, T., Shoemake, J., Nilsen, M. L., Czaja, S., Beach, S., & DeVito Dabbs, A. (2017). Patient portals as a tool for health care engagement: A mixed-method study of older adults with varying levels of health literacy and prior patient portal use. Journal of medical Internet research, 19(3), e99. https://doi.org/10.2196/jmir.7099

Kim, S., & Fadem, S. (2018). Communication matters: Exploring older adults’ current use of patient portals. International Journal of Medical Informatics, 120, 126-136. https://doi.org/10.1016/j.ijmedinf.2018.10.004

Nahm, E. S., Zhu, S., Bellantoni, M., Keldsen, L., Charters, K., Russomanno, V., … & Smith, L. (2020). Patient portal use among older adults: What is really happening nationwide?. Journal of Applied Gerontology, 39(4), 442-450. https://doi.org/10.1177%2F0733464818776125

Portz, J. D., Bayliss, E. A., Bull, S., Boxer, R. S., Bekelman, D. B., Gleason, K., & Czaja, S. (2019). Using the technology acceptance model to explore user experience, intent to use, and use behavior of a patient portal among older adults with multiple chronic conditions: Descriptive qualitative study. Journal of Medical Internet Research, 21(4), e11604. Doi: 10.2196/11604

Sieck, C. J., Hefner, J. L., & McAlearney, A. S. (2018). Improving the patient experience through patient portals: Insights from experienced portal users. Patient Experience Journal, 5(3), 47-54. doi: https://doi.org/10.35680/2372-0247.1269

Sinclair, A., Saeedi, P., Kaundal, A., Karuranga, S., Malanda, B., & Williams, R. (2020). Diabetes and global ageing among 65–99-year-old adults: Findings from the International Diabetes Federation Diabetes Atlas. Diabetes Research and Clinical Practice, 162, 108078. https://doi.org/10.1016/j.diabres.2020.108078

Assessment Description

Attachments

NRS-433V -RS1-LiteratureEvaluationTa

The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.

For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer-revised research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments.

Use the “Literature Evaluation Table” to complete this assignment.

Picot question created( Do obese patients (P) who receive nutritional education, diet and exercise (I), in comparison to those who do not (C), have improved health outcomes and weight loss (O) in a year’s time limit (T)?)

Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue.

Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).

The PICOT question will provide a framework for your capstone project.

Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem.

Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic Reviews, Literature Reviews, and Metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignment.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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

Attachments

NRS-433V -RS1-LiteratureEvaluationTable.d

PICOT Question and Literature Search – Rubric