NURS-FPX4030 | PICO (T) Questions and an Evidence-Based Approach
School: Capella University
Topic: PICO (T) Questions and an Evidence-Based Approach
Use of PICOT in management obesity
Application of PICOT framework can be vital in development of a care plan for individuals will chronic obesity. This tool focuses on the population/ patient, intervention, comparison, outcome and time for achievement of the set objectives. The management of the practice issue will allow for self-management of obesity among patients in the healthcare facility without the application or pharmacological interventions. The aim of the intervention will be to explore if non-pharmacological approaches are effective in comparison to pharmacologic intervention in reducing the cases of chronic obesity by 50% among the population in one year's time.
Non-pharmacological interventions incorporate adoption of patient-centred care to enhance delivery of wholesome health intervention (Higuera-Hernández et al., 2018). Besides, this approach will enable the participants be at the front line in management of obesity. The population under focus include individuals in the facility with a BMI of 30 or more. The objective is to evaluate the fundamental practices that can enable managing the issue of obesity without the application of pharmacological interventions. The exploration of this approach will benefit from a PICOT approach considering that it will be possible to identify the population of interest, the intervention including management approaches, comparison with pharmacologic interventions and the outcomes within a timeframe of 12 month.
Sources of evidence in answering a PICOT question
The Early Prevention of Obesity in Childhood (EPOCH) model is effective in evaluating prevalence of obesity in a community by addressing childhood obesity (Seidler et al., 2020). The importance of the tool arises from its ability to identify obesity at an early age and therefore come up with effective interventions. The EPOCH model enables for prediction of BMI trajectory and the prevalence of obesity at an early age (Askie et al., 2020). Therefore, this model creates an environment for assessment the epidemiological factors leading to development of obesity. The application of this model is vital to address in the critical parameters in managing of obesity such as cost implications. This model is also important in building support structure to enable individuals with obesity manage the condition at an early age (Tan et al., 2020). The importance of the evidence-based tools is to enable individuals with obesity tech prompt action that will allow for reduction in BMI and therefore reduce obesity in the stated time frame.
Health believe model
The use of health belief model is vital to manage obesity in the Healthcare sector. The concept behind the model indicates that individual will most likely follow healthy diet and adopt healthy lifestyle that would be vital to improve their overall health outcomes (Abdeyazdan, Moshgdar & Golshiri, 2017). The use of this approach will be vital to enable the individual adopt health promoting behaviours and identify barriers in achieving this perspectives. The fundamental recommendations of the model include important factors that influence healthy behaviours.
This aspect will be important to address these factors to enable managing obesity in a clinical setting. This approach can also be applied in managing obesity by addressing the PICOT question considering that it can be used to design short and long-term intervention towards this perspective. It is also possible to conduct a health needs assessment, communicate to the target population, provide assistance and eliminate barriers that may hinder achievement of obesity reduction. Therefore, this tool can be used to answer the PICOT question proposed in this essay.
Individualized intervention model
The importance of the model in answering the PICOT question arises from the ability to carry out needs assessment, evaluating past history, patient preferences and abilities of individuals with obesity. This model is an important source of evidence considering that it is a patient centred approach carried out by healthcare providers with vast experience and expertise in managing obesity by the use of non-pharmacological interventions.
According to Abhishek & Doherty (2018), the adoption of patient-centred care is an important non pharmacological approach in managing obesity among the population under study. This implies that self-management can play an important role in addressing cases of obesity by giving the individual autonomy to make healthy choices. The evidence presented by Mandal et al., (2018) indicates that combination of nutrition and exercise is vital in addressing cases of obesity among the population. This study presents significant evidence considering that the authors adopt a randomised controlled trial. The article is also peer- reviewed and written by individuals with high credibility in addressing the topic of obesity.
According to Salam et al., (2020), giving the patient ability to manage their health is an imperative aspect in attaining objective of reducing obesity. The evidence presented by the article illustrates that it is also imperative to offer Cognitive Behavioural Therapy (CBT) in combination with other non-pharmacological interventions such as diet and exercise. This study uses a randomised controlled trial and a meta-analysis in assessment of the topic of obesity management.
Relevance of the findings
The articles highlight the importance of adopting non-pharmacological approaches in managing obesity in the healthcare setting. These researches focus on the PICOT question by highlighting precisely evidence-based intervention practices with the conceptual clarity in addressing the topic of study. The findings provide reasonable evidence for adopting person-centred care considering that it leads to overall positive outcomes in the patient.
The rationale for selecting the article by Salam et al., (2020) is due to its ability to present a systematic review and meta-analysis of 20 primary intervention studies that focus on the topic of interest. The evidence presented in these articles is relevant considering that they are based on primary research including cluster randomised trials, controlled and uncontrolled trial conducted over the past five years. The findings by Mandal et al., (2018) are the most credible and a likely to lead to positive income considering that they are based on primary data in a healthcare setting with a large sample size. The authors also applied analytical tools to avoid bias and therefore attain credible evidence.
Abdeyazdan, Z., Moshgdar, H., & Golshiri, P. (2017). Evaluating the effect of lifestyle education based on health belief model for mothers of obese and overweight school-age children on obesity-related behaviors. Iranian journal of nursing and midwifery research, 22(3), 248.
Abhishek, A., & Doherty, M. (2018). Education and non-pharmacological approaches for gout. Rheumatology, 57(suppl_1), i51-i58.
Askie, L. M., Espinoza, D., Martin, A., Daniels, L. A., Mihrshahi, S., Taylor, R., ... & Baur, L. A. (2020). Interventions commenced by early infancy to prevent childhood obesity—The EPOCH Collaboration: An individual participant data prospective meta‐analysis of four randomized controlled trials. Pediatric obesity, 15(6).
Higuera-Hernández, M. F., Reyes-Cuapio, E., Gutiérrez-Mendoza, M., Rocha, N. B., Veras, A. B., Budde, H., ... & Murillo-Rodríguez, E. (2018). Fighting obesity: Non-pharmacological interventions. Clinical nutrition ESPEN, 25, 50-55.
Mandal, S., Suh, E. S., Harding, R., Vaughan-France, A., Ramsay, M., Connolly, B., ... & Hart, N. (2018). Nutrition and Exercise Rehabilitation in Obesity hypoventilation syndrome (NERO): a pilot randomised controlled trial. Thorax, 73(1), 62-69.
Salam, R. A., Padhani, Z. A., Das, J. K., Shaikh, A. Y., Hoodbhoy, Z., Jeelani, S. M., ... & Bhutta, Z. A. (2020). Effects of lifestyle modification interventions to prevent and manage child and adolescent obesity: a systematic review and meta-analysis. Nutrients, 12(8), 2208.
Seidler, A. L., Hunter, K. E., Johnson, B. J., Ekambareshwar, M., Taki, S., Mauch, C. E., ... & Golley, R. K. (2020). Understanding, comparing and learning from the four EPOCH early childhood obesity prevention interventions: A multi‐methods study. Pediatric Obesity, 15(11), e12679.
Tan, E. J., Taylor, R. W., Taylor, B. J., Brown, V., & Hayes, A. J. (2020). Cost‐Effectiveness of a Novel Sleep Intervention in Infancy to Prevent Overweight in Childhood. Obesity, 28(11), 2201-2208.