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Save Link Assignment Literature Review
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Due Date: Dec 16, 2018 23:59:59 Max Points: 100
Details:
While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone change proposal project, the literature review enables students to map out and move into the active planning and development stages of the project.
A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Statement Paper and Literature Evaluation Table assignments to develop a 750-1,000 word review that includes the following sections:
Title page
Introduction section
A comparison of research questions
A comparison of sample populations
A comparison of the limitations of the study
A conclusion section, incorporating recommendations for further research
Prepare this assignment according to the 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 LopesWrite. Please refer to the directions in the Student Success Center.
cover page, page #’s, refeences, running header Literarure review, follow rubric, I will upload picot and Literature review table with refernces M
Unformatted Attachment Preview
Running Head: PICOT
1
PICOT Statement on Diabetes
Gregory Catania RN
Grand Canyon University
NRS 490
11/25/18
2
PICOT
PICOT Statement on Diabetes
Over the past few decades, diabetes has become a predominant health concern in the world.
The prevalence of prolonged, non-communicable illnesses is increasing at a rapid rate. It is
estimated that about 19 million individuals die annually due to cardiovascular illness, for which
diabetes is the major underlying cause (Vakili et al., 2015). At the moment, over 1.7 billion adults
worldwide are overweight and 315 million of them being obese. The number of adults with type 2
diabetes is approximated to be 250 million and it is projected to increase to 400 million by 2025
(Marseglia et al., 2016). With these statistics, it implies that a diabetes epidemic is underway.
Diabetes occurs due to the impaired glucose sensitivity, whereby the blood glucose is too high.
The key risk factors for diabetes include obesity and physical inactivity. Research has proved that
the risk of developing diabetes can be significantly reduced by lifestyle changes (RuszkowskaGiastek et al., 2015). That said, this paper illustrates a PICOT statement on diabetes, especially on
adults, and how it can be controlled.
PICOT Question:
An increased glucose level is independently related to an increased A1C level. Does reducing the
A1C levels with specialized teaching from the nurse, practitioners, and dieticians help to control
diabetes on adult patients?
Population:
The population for the study are American adult patients diagnosed for type 2 diabetes, aging 40
to 60 years old. This population is heterogeneous with respect to comorbidities and general health
status, which is important to establishing the appropriate intervention.
3
PICOT
Intervention:
The intervention is quite essential as it explains on the way the researchers addressed the problem
and helped the population specified for the study. Implementation of dietary and lifestyle changes
would help control type 2 diabetes.
Comparison:
In order to determine whether the intervention is successful, A1C levels would be measured before
and after the changes in lifestyle and diet.
Outcome:
At the end of the study, it is expected that the A1C levels of adult diabetic patients would reduce.
Timeframe:
The research would be conducted over a period of 12 weeks.
PICOT Statement
Control of type 2 diabetes for American newly diagnosed adult patients has been problematic (P)
due to the poor lifestyle and diet, which leads to an increased glucose level. Specialized teaching
from the nurse, practitioners, and dieticians is an effective strategy to make the patients live
appropriately by eating the right food and doing exercises (I), which can enable them to control
their A1C levels (C) and live the normal life (O) within 12 weeks (T).
Education as regards to lifestyle modifications has been proved to be an effective
intervention for controlling type 2 diabetes. Kuo et al. (2015) indicate that lifestyle interventions
such as regular exercises and diet changes reduce the incidence of diabetes by 53 percent compared
4
PICOT
to the control group. People assigned to these interventions reported reduced A1C levels than the
control group. In a similar study by Islam, et al. (2014), changing the lifestyle plays a key role in
reducing in the glucose levels, which further minimizes the cases of diabetes by 27 percent.
Hence, there is an important relationship between increased glucose level and increased
A1C level as well as the lifestyle change and reduced A1C levels, which leads to effective control
of diabetes. Among patients with pre-diabetes, it is worth to control their diet and do regular
exercises to help in a decrease of diabetes occurrence. Failure to prevent diabetes means increased
mortality. It is, therefore, the responsibility of each person to ensure they are living a healthy life
to lower the risk of diabetes.
5
PICOT
References
Islam, S.M.S., Alam, D.S., & Wahiduzzaman, M., Nielsen, L.W, Fresch, G., Ferrari, U, Seisoler,
J, Rouf, H, M.A & Lechner, A. (2014). Clinical Characteristics and Complications of
Patients with Type 2 Diabetes Attending an Urban Hospital in Bangladesh. Diabetes and
Metabolic Syndrome: Clinical Research Reviews, 1-7
Kuo, Y., Goodwin, J.S. & Chen, N. Lwin, K.K., Baillargeon, J., & Raji, M.A. (2015). Diabetes
Mellitus Care Providers by Nurse Practitioners versus Primary Care Physicians, Journal
of American Geriatric Society. 63 (10), 1980-1988
Marseglia, A., Fratigioni, L., Laukka, E.J., Santoni, G., Pedersen, J., Backman, L. & Xu, W.
(2016). Early Cognitive Deficits in Type 2 Diabetes A Population Based Study. Journal
of Alzheimer Disease. 53, 1069-1078
Ruszkowska-Giastek, B., Sollup, A., Wernik, T., Rupiecht, Z., Golalczkyk, K., Gadomska, G. &
Rosc, D. (2015). Effect of Uncontrolled Hyperglycemia on levels of Adhesion Molecules
in Patient with Diabetic Mellitus Type 2. Zhejiang University- Science (Biomedical and
Biotechnology) 16 (5), 355-361
Vakili, S.T.T., Nezami, B.G., Shetty, A., Chetty, V.K. & Srinivasan, S. (2015). Association of
High Dietary Saturated Fat Intake and Uncontrolled Diabetes with Constipation:
Evidence from the National Health and Nutrition Examination Survey. Neurogastoral
Motil, 27 (10), 1389-1397
Literature Evaluation Table
Student Name: Gregory Catania RN
Change Topic (2-3 sentences): Better Diabetic A1C control in outpatient adult clinic with
specialized nursing visits that include education, lifestyle changes, medications and diet.
Criteria
Author, Journal
(Peer-Reviewed),
and
Permalink or
Working Link to
Access Article
Article 1
Article 2
Islam, S.M.S. et al.
Journal of Diabetes &
Metabolic Syndrome,
Clinical Research & Reviews
http://dx.doi.org/10.1016/j.ds
x.2014.09.014
Marseglia, A. et al.
Journal of
Alzheimer’s
Disease Vol. 53,
p.1069-1078
http://dx.doi.org/10
.3233/JAD-160266
Article 3
Kuo, Y. et al.
Journal of American
Geriatric Society
(10), 1980-1988
https://doi.org/10.111
1/jgs.13662
Clinical Characteristics and
Complications of Patients
with Type 2 Diabetes
Attending an Urban Hospital
in Bangladesh
(2014)
Early Cognitive
Deficits in Type 2
Diabetes A
Population Based
Study
(2016)
Diabetes Mellitus
Care Providers by
Nurse Practitioners
versus Primary Care
Physicians
(2015)
Research
Questions
(Qualitative)/Hypo
thesis
(Quantitative), and
Purposes/Aim of
Study
To find out the relationship
of social economic factors in
T2D with complications of
diabetes
To explore biochemical
characteristics in T2D and
diabetic related
complications
To find out diabetic related
complications among Pt
taking oral medications and
development of
complications
To find out if
uncontrolled
diabetes has an
effect on cognitive
function- a
predisposition to
dementia
To explore
differences in cost of
care between Nursing
practitioners
compared with
primary care
physicians
Study explored eye
examination,
cholesterol, HbA1C,
neuropathy, referrals
and costs between NP
and Primary
physicians.
The study aim: to
investigate if there is
a difference in cost
and level of care
between Nursing
practitioners and
primary care
Study aim: To investigate
the clinical features of
patients with type 2 diabetes
on oral medications and
determine the complications
and risk factors in the
patients (515).
Study Aim: To
find out the effect
of uncontrolled
Almadhoun, M.R
et al.
Journal of
Clinical and
Experimental
pharmacology 8
(3), p.1-10
DOI:10.4172/21611459.1000250
Article Title and
Year Published
Purpose of the
study is to find out
if diabetes
contributes to risk
of dementia (196)
Article 4
© 2015. Grand Canyon University. All Rights Reserved.
Assessment of
Medication
Adherence and
its association
with glycemic
control among
type 2 diabetes
mellitus patient
in Gaza
(2018)
To find out if
medication
adherence has
any effect on
glycemic control
among T2D
patients
Quantitative
study
diabetes on the risk
of dementia
physicians
The study was a
cross-sectional
quantitative study
Sample size was
196 in a home for
the elderly in
Sweden
Retrospective cohort
study
Cross-sectional
study
Evaluating data
provided by
Medicaid from
beneficiary of
primary care
N=64,354
The data collected
was coded and
analyzed with regard
to study variables
T2D in Gaza
attending
diabetic clinic
Sample size 148
Design (Type of
Quantitative, or
Type of
Qualitative)
Setting/Sample
Study was a cross-sectional
quantitative inquiry
Methods:
Intervention/Instru
ments
Mixed method data collected
through questionnaire, face to
face interview, laboratory
investigations
ECG, eGFR, Blood pressure
machine, observation during
outpatient visit
The collected data was
analyzed using descriptive
statistics, and inferential
statistics. The analysis
deployed used t-test, logic
analysis and simple logic
regression analysis
Methods included
observation,
laboratory tests,
cognitive functions
tests
Analysis was done
using multivariate
linear regression to
estimate
differences and
multi-nominal
logistic regression
to examine
association
Statistical Logistic
regression model
The study revealed that even
in the best clinical setting the
control of diabetes was
suboptimal. Average HBA1C
was 8.3; hypertension 51%,
71% had uncontrolled T2D.
Uncontrolled diabetes led to
eye complications (68.9%),
chronic kidney disease
(21.3%), CVD (11.8%) and
Neurological issues (2.5)
from the study subjects.
There is need to have
consistent screening using
HBA1C goal, reduce BP and
addition of statins to
treatment regimens to help
lower high cholesterol.
The study reported
that uncontrolled
diabetes exposes
patient to risk of
dementia.
There was no
significant difference
the two groups
regarding costs
except Nursing
practitioners rarely
performed eye
examinations, there is
risk of Nursing
practitioners Rx
wrong medications
Control is diabetes
is essential in
reducing risks
associated with
diabetic
complication.
Diabetic control
will delay
cognitive problems
in patient T2D
Controlling
diabetes help delay
cognitive function
impairment, nurses
can help patients
There is need to have
a treatment protocol
that investigates eyes,
Hb AIC, CVD,
Neurological
complications to
improve primary care
Need to improve
medical
adherence to
improve T2D
glycemic control
Nurses have a
significant role in
helping patient with
T2D manage tighter
glycemic control.
The article is
important
because
adherence to
drugs leads to
Analysis
Key Findings
Recommendations
Explanation of
How the Article
Supports
EBP/Capstone
Project
Sample size 515 patient at
outpatient setting.
The article recommends
control of blood sugar as a
means of reducing diabetic
complications. PICOT study
seeks to enhance the use of
© 2017. Grand Canyon University. All Rights Reserved.
Patients were
followed through
face to face
questionnaire,
laboratory
examination to
monitor progress
Descriptive
statistics and
inferential
statistics done.
Regression
analysis to
determine
influence of
independent
variables
The study found
out that majority
of the patients
did not comply
with treatment
instruction
leading to 56.1%
having poor
control.
HBA1C as measure of
controlling T2D through
education, screening and
patient management in diet &
lifestyle change because
drugs alone are insufficient.
Criteria
Author, Journal
(Peer-Reviewed),
and
Permalink or
Working Link to
Access Article
Article 5
gain proper control
through education,
diet, exercise and
medication
Article 6
Nurses can help
patient and doctors
achieve targeted Hb
AIC < 6.4
Article 7
better glycemic
control
Article 8
Ruszkowska-Giastek, B.
et al.
Vakili, S.T.T. et al.
Wol, S.K. et al.
Kostev, K. et al.
Zhejiang UniversityScience (Biomedical
and Biotechnology)
Neurogastoral
Motil, 27 (10),
1389-1397
Journal of Korean
Academy of
Nursing 48 92)
182-194
Journal of
Diabetes,
science and
technology
https://doi.org/10.4
040/jkan.2018.48.2
.182
https://doi.org/10
.1177/193229681
7710477
Prescription
Patterns in
Disease control
in T2D Mellitus
in Nursing home
and Home care
setting:
Retrospective
Analysis in
Germany
(2018)
To determine the
influence of
treatment setting
on diabetes
control
https://link.springer.com/c
ontent/pdf/10.1631%2Fjz
us.B1400218.pdf
https://dx.doi.org/10.
1111%2Fnmo.12630
Article Title and
Year Published
Effect of Uncontrolled
Hyperglycemia on levels
of Adhesion Molecules in
Patient with Diabetic
Mellitus Type 2
(2015)
Association of High
Dietary Saturated Fat
Intake and
Uncontrolled
Diabetes with
Constipation:
Evidence from the
National Health and
Nutrition (2015).
The effects of
health mentoring
program in
community
dwelling
vulnerable elderly
individuals with
diabetes
(2018)
Research
Questions
(Qualitative)/Hyp
othesis
(Quantitative),
and Purposes/Aim
of Study
To evaluate the
concentration of soluble
forms of vascular
adhesion in patient with
controlled and
uncontrolled diabetes type
2
Cross-sectional
Quantitative study
Hypothesis there is
no relationship
between diabetes and
constipation.
To determine the
influence of
mentoring in the
community on
health treatment
outcome in T2D
Design (Type of
Quantitative, or
Type of
Qualitative)
Setting/Sample
The Study was a
quantitative controlled
randomized inquiry
Examination Survey
Poland sample size 62
with 35 diabetic, 27
diabetic uncontrolled and
25 healthy subjects
Diabetic patients
non- Hispanic 6207
subjects
Methods:
Intervention/Instr
uments
Laboratory analysis,
urine, blood and kidney
function tests
Physical and
laboratory
examination, BMI,
Cross –sectional
study, randomized,
control,
quantitative design
Korea setup with
elderly at risk of
dementia, diabetes
complications 96 at
the start and 70 at
study end.
Follow up,
laboratory analysis
© 2017. Grand Canyon University. All Rights Reserved.
Quantitative
longitudinal
comparative
study
Germany
comparing T2D
in nursing homes
and at home
9850 subjects /2
Analyzed, stored
data between
2011 and 2015
diet water intake
Analysis
Statistical analysis
involved test for
normality, ANOVA for
variance and Pearson
correlation analysis to test
relationship among
variables
Control of diabetes delays
vascular impairment
Descriptive Statistics
and inferential
statistical analysis
was deployed
Descriptive
Statistical and
inferential statistics
analysis
Statistical
analysis using
Wilcoxon tests
and Chi squared
test to compare
analyze results
There is a significant
relationship between
diabetic patients and
constipation
compared to no
diabetic subjects
Mentoring is an
effective strategy
in monitoring the
diabetic patients in
the community
Recommendations
Doctors need to ensure
tight control of diabetes to
prevent vascular
complications and
neuropathy
Diet is instrumental
in managing diabetes
and ensuring Hb AIC
targets are reached
for tighter glucose
control.
Mentoring need to
be incorporated in
management of
T2D in the
community
Explanation of
How the Article
Supports
EBP/Capstone
Control of Diabetes
delays diabetic related
complication including
vascular impairment,
CVD and heart disease
The article is
important because
diabetic control can
help reduce
constipation in T2D
pts
The nurses are
important as
treatment
facilitators in the
community with
regard to education
There was no
significant
different between
the two groups.
The mean age at
the nursing
homes 80.7 years
and those at
home 74.8 years.
Patients in any
set up provided
adequate
education is
offered treatment
goals will be
achieved.
The article is
vital because
nurses attend to
patient’s
outpatient and
inpatient nurses
facilitate
glycemic control.
Key Findings
© 2017. Grand Canyon University. All Rights Reserved.
Literature Review
1
Unsatisfactory
0.00%
80.0 %Content
10.0 %Introduction
2
Less than
Satisfactory
75.00%
3
Satisfactory
79.00%
4
Good
89.00%
5
Excellent
100.00%
An introduction is An introduction is An introduction is An introduction is An introduction is
not present.
present, but it
present, and it
present, and it
present, and it
does not relate to relates to the
relates to the
relates to the
the body of the body of the paper. body of the
body of the
paper.
There is nothing in paper.
paper.
the introduction Information
Information
to entice the
presented in the presented in the
reader to continue introduction
introduction is
reading.
provides incentive intriguing and
for the reader to encourages the
continue reading. reader to
continue reading.
20.0 %Comparison of No comparison of A comparison of A cursory though A moderately
A reflective and
Research Questions research
research
valid comparison thorough and
insightful
questions is
questions is
of research
valid comparison comparison of
presented.
presented, but it questions is
of research
research
is not valid.
presented.
questions is
questions is
presented.
presented.
20.0 %Comparison of No comparison of A comparison of A cursory though A moderately
A reflective and
Sample Populations sample
sample
valid comparison thorough and
insightful
populations is
populations is
of sample
valid comparison comparison of
presented.
presented, but it populations is
of sample
sample
is not valid.
presented.
populations is
populations is
presented.
presented.
20.0 %Comparison of No comparison of A comparison of A cursory though A moderately
A reflective and
the Limitations of
the limitations of the limitations of valid comparison thorough and
insightful
the Study
the study is
the study is
of the limitations valid comparison comparison of the
presented.
presented, but it of the study is
of the limitations limitations of the
is not valid.
presented.
of the study is
study is
presented.
presented.
10.0 %Conclusion
No conclusion and A conclusion and A conclusion and A conclusion and A conclusion and
and
recommendations recommendations recommendations recommendations recommendations
Recommendations for further
for further
for further
for further
for further
for Further Research research are
research are
research are valid, research are valid research are
presented.
presented, but
but they are
and moderately reflective and
they are not
cursory.
thorough.
insightful.
valid.
15.0 %Organization
and Effectiveness
5.0 %Thesis
Paper lacks any Thesis is
Thesis is apparent Thesis is clear and Thesis is
Development and
discernible
insufficiently
and appropriate to forecasts the
comprehensive
Purpose
overall purpose or developed or
purpose.
development of and contains the
organizing claim. vague. Purpose is
the paper. Thesis essence of the
not clear.
is descriptive and paper. Thesis
reflective of the statement makes
arguments and
the purpose of
appropriate to the the paper clear.
purpose.
5.0 %Argument Logic Statement of
Sufficient
Argument is
Argument shows Clear and
and Construction
purpose is not
justification of
orderly, but may logical
convincing
justified by the claims is lacking. have a few
progressions.
argument that
conclusion. The Argument lacks inconsistencies. Techniques of
presents a
conclusion does consistent unity. The argument
argumentation
persuasive claim
not support the There are obvious presents minimal are evident.
in a distinctive
claim made.
Argument is
incoherent and
uses noncredible
sources.
5.0 %Mechanics of
Writing (includes
spelling,
punctuation,
grammar, language
use)
5.0 %Format
2.0 %Paper Format
(use of appropriate
style for the major
and assignment)
flaws in the logic. justification of
There is a smooth
Some sources
claims. Argument progression of
have questionable logically, but not claims from
credibility.
thoroughly,
introduction to
supports the
conclusion. Most
purpose. Sources sources are
used are credible. authoritative.
Introduction and
conclusion bracket
the thesis.
Surface errors are Frequent and
Some mechanical Prose is largely
pervasive enough repetitive
errors or typos are free of
that they impede mechanical errors present, but they mechanical
communication of distract the
are not overly
errors, although a
meaning.
reader.
distracting to the few may be
Inappropriate
Inconsistencies in reader. Correct
present. A variety
word choice or
language choice sentence structure of sentence
sentence
(register),
and audiencestructures and
construction is
sentence
appropriate
effective figures
used.
structure, or word language are
of speech are
choice are
used.
used.
present.
Template is not
used
appropriately or
documentation
format is rarely
followed
correctly.
3.0 %Documentation Sources are not
of Sources
documented.
(citations,
footnotes,
references,
bibliography, etc.,
as appropriate to
assignment and
style)
100 %Total
Weightage
Template is used, Template is used,
but some
and formatting is
elements are
correct, although
missing or
some minor errors
mistaken; lack of may be present.
control with
formatting is
apparent.
Documentation of Sources are
sources is
documented, as
inconsistent or
appropriate to
incorrect, as
assignment and
appropriate to
style, although
assignment and some formatting
style, with
errors may be
numerous
present.
formatting errors.
and compelling
manner. All
sources are
authoritative.
Writer is clearly
in command of
standard, written,
academic English.
Template is fully All format
used; There are elements are
virtually no errors correct.
in formatting
style.
Sources are
documented, as
appropriate to
assignment and
style, and format
is mostly correct.
Sources are
completely and
correctly
documented, as
appropriate to
assignment and
style, and format
is free of error.
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