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RUNNING HEAD EVIDENCE BASED PRACTICES TI GUIDE CLINICAL PRACTICES 2

 

 

 

 

 

Research Evidence Practice in Nursing

 

 

 

Milena Hernandez

Miami Regional University

COURSE:  Research and Evidence Based Practice

COURSE CODE: NUR4100

04/01/2021

 

The relationship between the theory, research, and the evidence-based practice

Based on the existing relationship between these three aspects, the theory is considered to be knowledge that is generated from the research work. The theory is arrived at after thorough systematic and scientific investigation to the research questions or testing of the hypothesis. The connection between the research and the theory is reciprocal where the research is helping in the generation of more knowledge and theory. The theory is therefore considered to be statements that are used to illustrate the existence of the relationship between two concepts (Smith, 2018).

Concerning the relationship between the research and the evidence-based practice (EBP); EBP is considered to be the process of using a confirmed evidence i.e., the research and the quality enhancement; the decision-making; and the nursing skills to help in guiding the process of delivering holistic patient care by the nurses. Most of these pieces of evidence are stemming from the research, nevertheless, the evidence-based practice is going beyond the use of the research and it involves the clinical skills and the patient preferences, and values. Research is involving the development of knowledge whereas evidence-based is involving the innovation process of the findings and translation of the best into the practice within the clinical settings (Tomlinson et al., 2018).

The discussion of the research questions, sampling, sampling size, research designs, hypothesis, data collection methods, and the research findings

Sebire et al (2018) focused on quantitatively exposing how the patient groups are articulating and experiencing various categories of motivation while trying to change their lifestyle. This was aimed at exploring how the individuals who had recently been diagnosed with type 2 diabetes experienced and managed their conditions. The data were also targeted at effectively implementing and recognising the enhancements to the intervention.

The authors used purposive sampling to ensure that the interviews were carried out with the study subjects in every trial arm, men and women of different ages, and from various sites. The study design adopted in this article is the interview that was collected with the individuals who had been diagnosed earlier with type 2 diabetes and had participated earlier in the Early ACTivity In Diabetes (ACTID) trial. A sample of 30 participants i.e., 18 females and 12 males with newly diagnosed type 2 diabetes and took part in the ACTID trial were recruited.

A secondary semi-structured interview assessment was used for the collection of the data from the 30 study participants who were recruited to take part in the study. The interviews were carried out face to face for about 6 months and through telephone for 9 months after the randomization process. The hypothesis used in the article is that motivation after diagnosis with type 2 diabetes leads to changes in physical activity and dietary behaviors.

The findings of the study showed that there are differences in the quality of motivation for both between and within persons with time. Another finding is that newly diagnosed diabetes is complicated with competing motivations for the changes in lifestyle behaviors. The majority of the participants showed dominant controlled motivation to adhere to the lifestyle proposals, avoiding their non-adherence being discovered or suppressing the guild after the relapse in their trial to change the behaviors. These experiences also include frustrations which lead to the slow progress in the behavioural changes (Sebire, et al., 2018).

Liang et al (2016) performed a meta-analysis of the observational studies aimed at determining whether diabetic patients who is being operated on is at high risk of bedsore. The study was based on the systematic research review of the articles through a searching database such as Pubmed, EMBASE, and Cochrane Library. Based on the search outcomes, a total of 16 studies have generated a total of 24,112 individuals being included in the meta-analysis (Liang, et al., 2017). The research articles generated for this study had different study designs with some of them based on the prospective studies while others based on retrospective studies.

The authors of this article carried out a systematic review and meta-analysis using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) to help in the collection of data. The collection of the data was also based on the manual searches for some of the missing citations (Liang, et al., 2017). Data were extracted independently and were based on the pre-designed for using two reviewers i.e., Y.Z and L.H. A third reviewer, L.L re-assessed the extracted data to determine whether there was an agreement.

Based on the study findings, the analysis reveals that there is a greater risk of cardiac surgery as compared to other investigated surgical procedures such as general, hip, and lower extremities amputation surgical process. The study also reveals the higher risk of surgical-related bedsores amongst the diabetic clients that individuals not yet diagnosed with diabetes. The general, hip, and cardiac surgical procedures have greater risk to bedsores than non-diabetic patients. the findings also reveal different mechanisms that are contributing to the development of the severe bedsores. Most of the bedsores occur from the capillary obstruction by the external pressure which leads to the blood supply being shut off, death of the cells, removal of necrosis, and development of ulcers. The study also reveals that time taken for the pressure to occur in the local region determines the severity of the bedsores (Liang, et al., 2017).

The goals, health outcomes, and implementation approaches

A study by Liang et al (2017) performed a systematic literature search using a database such as Pubmed, Embase, and Cochrane Library. The focus of the study was to determine whether patients undergoing surgery are at higher risk of developing bedsores. The focus of the study in this case is the patients who have been diagnosed with diabetes disease (Rowe et al., 2018). The outcomes of this study reveal that diabetic patients in surgical procedures are highly exposed to the risk of bedsores development.

This outcome is providing an opportunity for the development of evidence-based practice to help in the prevention of risk for developing bedsores among diabetic patients undergoing surgery. The issue of bedsores tampers with the quality healthcare services that are being received by the patients. therefore, the focus, in this case, is to ensure that there is the existence of evidence-based intervention that can be implemented by the nurses to reduce such risks. Some of the interventions that can be used in surgical wards to prevent the development of bedsores are repositioning or turning the client, providing further nutritional supplementation, negative wound therapy, use of the borderless foam dressings, and the use of multi-layered soft silicon dressings among others (Rowe et al., 2018).

The focus of Sebire et al (2018) in their study was on exploring quantitatively how the patient is articulating and experiencing various types of motivation when attempting to change their lifestyle. The study reveals motivation as an important approach that can be used to help patients ensure that they are free from the complications associated with poor management of type 2 diabetes. The successful management of this condition does not only require physician intervention but also efforts from patients. patients are required to adopt healthy behaviors like taking healthy meals and active involvement in physical exercise.

The outcome of this research article reveals some of the complications associated with the motivation to the lifestyle changes after diagnosis with this condition. The study also reveals the role of the autonomous motivation which is always achieved over time. Adherence to the recommendations made by the doctor concerning the successful management of type 2 diabetes requires motivation to prevent the possibility of relapse. Participation in physical exercise activities and observing healthy nutrition should remain a priority of the healthcare provider when motivating the patients.

For the patients, the process or understanding of type 2 diabetes management is an essential factor. Motivation for lifestyle behavioral changes is an essential aspect of successful promotion of patient-centeredness in the management of the condition through adherence to a healthy practice. The first experience after being diagnosed with type 2 diabetes might come with a shock, therefore, these patients require motivation while dealing with the issue (Sebire, et al., 2018). The study reveals the importance of motivation in overcoming internal conflict, frustrations, and the need for external prompting.

Even though some individuals might have autonomous motivation concerning the approach they might give to the behavioral changes with increased flexibility, nurses need to use motivation as an evidence-based intervention to support patients diagnosed with this condition. The nurses need to understand the quality of motivation and the type of motivation that is targeted at the modification of lifestyle (Sebire, et al., 2018).

The credibility of the sources

While considering the qualification of the authors to determine the authenticity of their work, a study by Sebire et al (2018), there is no clear evidence concerning the profession or the place of employment for the authors. On the other hand, a study by Liang et al (2017) contains information that shows the qualifications as well as the institution of employment of the authors. In this article, the authors work at the department of psychiatry, department of nursing, nursing, and teaching and research institute.

The study by Sebire et al (2018), was funded by the NIHR Biomedical Research Center at the University of Hospitals Bristol NHS Foundation Trust at the University of Bristol. On the other hand, the study by Lang et al (2017) does not reveal any source of funding from any institution. Based on the study sample used, the sample size presented by Lang et al (2017) has a limited sample size as well as significant heterogeneity that made the result of the study to be less reliable. On the other hand, the sample size used in the article by Sebire et al (2018) reveals about larger sample size. This makes it possible to conclude that the study outcome was correct. The sample size used in this case also makes it possible to generalize that motivation after diagnosis with type 2 diabetes leads to positive changes in terms of adopting the lifestyle changes. It also makes it possible to generalize the outcome for the entire regions or the population that was targeted by the study.

 

References

Liang, M., Chen, Q., Zhang, Y., He, L., Wang, J., Cai, Y., & Li, L. (2017). Impact of diabetes on the risk of bedsores in patients undergoing surgery: an updated quantitative analysis of cohort studies. Oncotarget, 8(9), 14516. www.impactjournals.com/oncotarget Rowe, A. D., McCarty, K., & Huett, A. (2018). Implementation of a nurse-driven pathway to reduce the incidence of hospital-acquired pressure injuries in the pediatric intensive care setting. Journal of pediatric nursing, 41, 104-119. https://doi.org/10.1016/j.pedn.2018.03.001 Sebire, S. J., Toumpakari, Z., Turner, K. M., Cooper, A. R., Page, A. S., Malpass, A., & Andrews, R. C. (2018). “I’ve made this my lifestyle now”: a prospective qualitative study of motivation for lifestyle change among people with newly diagnosed type two diabetes mellitus. BMC Health Public, 18, 204. doi:10.1186/s12889-018-5114-5 Smith, L. (2018). The Relationship Among Theory, Research, and Practice: Philosophies, Theories, Models, and Taxonomies. doi:10.1891/9780826133236.0003 Tomlinson, J., Baird, M., Berg, P., & Cooper, R. (2018). Flexible careers across the life course: Advancing theory, research, and practice. Human Relations, 71(1), 4-22. https://doi.org/10.1177/0018726717733313

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