PICO(T) Questions and an Evidence-Based Approach

PICO(T) Questions and an Evidence-Based Approach

The PICOT model is a research tool that facilitates researchers’ access to necessary resources. The empirical methodology makes it possible for the researcher to have a set of questions that direct the researcher on the right path that leads to locating the best research sources. For better policies to be put in place that enable patients to gain the best care, the patients have put up care practices to follow this approach. PICOT is an acronym formed by the initial letters of the five components of the problem, namely: patients, comparison, interventions, outcomes, and timeline. This paper is going to employ the PICOT study methodology to assist us in accessing the health resources that will help in tackling the problem of COPD patients.

A PICO(T) Formatted Research Question

The primary factor causing damage to the respiratory system in COPD patients is inflammation. Consistently, emphysema and chronic bronchitis are the most frequent lung disorders in COPD patients (Mosenifar, 2019). Because of the aggressive nature of the disease, it worsens with time. Even though treatment is a good way of managing the condition, a more effective treatment regimen that encompasses non-pharmacological intervention is necessary for the management of patients who experience attacks, which is especially for patients who do not have regular hospital visits. Taking this into account, the inquiry being investigated is: Are non-pharmacologic options for COPD patients targeting themselves to prevent or reduce acute exacerbations more effective than the pharmaceutic treatments?

Patients with COPD are the demographic that is being examined, and these patients are essentially individuals who are recuperating at home and who frequently experience exacerbations. This has led to the development of patient-centered interventions, which place the patient at the center of the delivery of healthcare and are non-pharmacological. This is accomplished by highlighting the patient’s experiences and communication about the specified healthcare problem. For COPD exacerbations, a comparison of pharmaceutical and non-pharmacological therapies will be made. By aiding in the discovery of non-pharmacological treatment options, the study seeks to significantly minimize exacerbations (Ko et al., 2019). Although cultural factors have been considered about the patients, their influence was minimal because these aspects were not included in the interventions. The research will be conducted over two months to identify the best knowledge sources and study time.

Sources of Evidence that Could be Potentially Effective in Answering a PICO(T) Question

Finding reliable resources requires consideration of the patient-centered nature of the intervention approach, which is reflected in the PICOT questions. Some specific models that can aid in improving the search are the Individual intervention Model, Swiss Cheese Model, and Dice model.

Individual intervention Model

The approach makes use of the COPD patients’ requirements, preferences, talents, and history. With a focus on the unique aspects of each patient as they present in the care, the model improves patient-centered care-based activities performed by healthcare professionals (Cravo et al., 2022). Primary training in social services, leisure therapy, guidance, and psychology is provided to the major healthcare professionals. These fields are related to the emotional welfare of patients in terms of healthcare delivery.

Swiss Cheese Model

Despite being a systemic model, this one can be utilized to improve and identify interventions that can assist individuals with COPD who are experiencing exacerbations. It can also be applied in a patient-centered manner, which centers the care process around the needs of the patient. The purpose of the Swiss cheese model is to integrate several relevant actions and offer fixes for problems as they emerge until the problems have been fully remedied. The model functions similarly to a multi-holed Swiss cheese (Wiegmann et al., 2021). The defense mechanism is strengthened by the addition of many layers that fully enclose the gaps. Using this kind of patient-centered strategy, a solution may be identified, but it may have issues that need to be handled by another approach. This process continues until all issues have been found and resolved in a way that effectively meets the demands of the patient.

Dice model

DICE stands for “describing, examining, producing, and assessing.” It is a widely used patient-centered care model that determines the optimal course of action for Alzheimer’s patients, yet the COPD patients included in this research can also benefit from it (Eikelboom et al., 2023). Experts from the University of Michigan Programme for Positive Ageing developed the paradigm, which consists of four steps. The procedures involve discussing the patient’s problems, looking into the underlying cause, developing treatment plans, and then reviewing and evaluating the effectiveness of the tactics that were put forth.

Findings from Resources

As indicated in this research, patient-centered care is a well-known non-pharmacological strategy that can be applied to COPD patients. The best way to determine the approach’s efficacy is to contrast the suggested non-pharmacological care techniques with pharmacological care approaches. Pharmacological treatment essentially entails using medicine to treat COPD and manage potential exacerbations. The most widely used pharmacological treatments for COPD include glucocorticosteroids, bronchodilators (such as receptor agonists, methylxanthines, and anticholinergics), and other drugs such as antioxidants, vasodilators, and antibiotics (Rosenwasser et al., 2022). Although these have shown to be useful in lessening exacerbations, they also have certain adverse effects that are detrimental to the patient. Furthermore, because of their high cost, not all COPD patients can afford the type of medication that will help them with their illnesses. Therefore, non-pharmacological methods can significantly improve COPD treatment.

Research has shown that non-pharmacological treatments are more effective and convenient to use; patients can pursue them on their own. The most prominent one, based on studies, was giving up smoking. The primary characteristic of COPD patients has been discovered to be smoking, and quitting can have significant benefits for the patients. Patients with COPD can benefit from improved patient care and fewer exacerbations by using self-management strategies through comprehensive care plans, oxygen treatment, and noninvasive ventilation (Sigurgeirsdottir et al., 2019). These were all discovered through research and may eventually have a big impact on patient care and development.

Relevance of the Findings

A crucial study by Volpato et al. (2023) offered an extensive number of illustrations of non-pharmacological strategies and how they might support patients with COPD in managing their illnesses through patient-centered treatment. This resource was also useful in applying different models in clinical practice and offered the required instruction on the use of different models in clinical research. An important study by Schrijver et al. (2022) addressed the issue of self-management and demonstrated why non-pharmacological therapies are the most effective in treating COPD. Using Yi et al. (2021), research was essential in delivering comprehensive results that improved the study and identified therapies and their efficacy in assisting patients with their COPD illnesses.

Using the PICOT paradigm for nursing research was made easier by Sguanci et al. (2023), a resource that was required for this article. After reading this book, the majority of the models were put forth and the problem was made clear, and it assisted in developing a framework that was useful for the research. It was utilized in conjunction with the paper by McClinton (2022), which supported the PICOT question.

To sum up, it is imperative to employ non-pharmacological methods as therapies for exacerbations of COPD. The PICOT model was employed in the study to develop patient-centered care strategies that would identify the most effective fixes for the issues found. It is anticipated that the results will offer a solid foundation for additional study in this area. The resources offered were beneficial and improved the study.

References

Cravo, A., Attar, D., Freeman, D., Holmes, S., Ip, L., & Singh, S. J. (2022). The Importance of Self-Management in the Context of Personalized Care in COPD. International Journal of Chronic Obstructive Pulmonary Disease, 17(17), 231–243. https://doi.org/10.2147/COPD.S343108

Eikelboom, W. S., Esther, Michiel Coesmans, Goudzwaard, J. A., Koopmanschap, M., Najoua Lazaar, Bruchem-Visser, van, Jan J.M. Driesen, Tom den Heijer, Hoogers, S., Jan, F., Mattace-Raso, F., Thomeer, E. C., Vrenken, S., Lilian J.H.M. Vroegindeweij, Zuidema, S. U., Singleton, E. H., John, Rik Ossenkoppele, & Papma, J. M. (2023). Effects of the DICE Method to Improve Timely Recognition and Treatment of Neuropsychiatric Symptoms in Early Alzheimer’s Disease at the Memory Clinic: The BEAT-IT Study. Journal of Alzheimer’s Disease, 93(4), 1407–1423. https://doi.org/10.3233/jad-230116

Ko, F. W. S., Chan, K. P., & Hui, D. S. C. (2019). Comprehensive care for chronic obstructive pulmonary disease. Journal of Thoracic Disease, 11(S17), S2181–S2191. https://doi.org/10.21037/jtd.2019.09.81

McClinton, T. D. (2022). A guided search: Formulating a PICOT from assigned areas of inquiry. Worldviews on Evidence-Based Nursing, 19(5). https://doi.org/10.1111/wvn.12598

Mosenifar, Z. (2019). Chronic Obstructive Pulmonary Disease (COPD): Practice Essentials, Background, Pathophysiology. Medscape.com. https://emedicine.medscape.com/article/297664-overview

Rosenwasser, Y., Berger, I., & Loewy, Z. G. (2022). Therapeutic Approaches for Chronic Obstructive Pulmonary Disease (COPD) Exacerbations. Pathogens, 11(12), 1513. https://doi.org/10.3390/pathogens11121513

Schrijver, J., Lenferink, A., Brusse-Keizer, M., Zwerink, M., van der Valk, P. D., van der Palen, J., & Effing, T. W. (2022). Self-management interventions for people with chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, 2022(1). https://doi.org/10.1002/14651858.cd002990.pub4

Sguanci, M., Mancin, S., Piredda, M., Cordella, F., Tagliamonte, N. L., Zollo, L., & De Marinis, M. G. (2023). Nursing-Engineering Interdisciplinary Research: a synthesis of methodological approach to perform Healthcare-Technology integrated projects. MethodsX, 102525. https://doi.org/10.1016/j.mex.2023.102525

Sigurgeirsdottir, J., Halldorsdottir, S., Arnardottir, R. H., Gudmundsson, G., & Bjornsson, E. H. (2019). COPD patients’ experiences, self-reported needs, and needs-driven strategies to cope with self-management. International Journal of Chronic Obstructive Pulmonary Disease, Volume 14(14), 1033–1043. https://doi.org/10.2147/copd.s201068

Volpato, E., Farver-Vestergaard, I., Brighton, L. J., Peters, J., Verkleij, M., Hutchinson, A., Heijmans, M., & Leupoldt, A. von. (2023). Non-pharmacological management of psychological distress in people with COPD. European Respiratory Review, 32(167). https://doi.org/10.1183/16000617.0170-2022

Wiegmann, D. A., J. Wood, L., N. Cohen, T., & Shappell, S. A. (2021). Understanding the “Swiss Cheese Model” and Its Application to Patient Safety. Journal of Patient Safety, Publish Ahead of Print(2), 119–123. https://doi.org/10.1097/pts.0000000000000810

Yi, Q.-F., Yang, G.-L., & Yan, J. (2021). Self-Efficacy Intervention Programs in Patients with Chronic Obstructive Pulmonary Disease: Narrative Review. International Journal of Chronic Obstructive Pulmonary Disease, Volume 16, 3397–3403. https://doi.org/10.2147/

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Create a 3-5 page submission in which you develop a PICO(T) question for the diagnosis (COPD) you worked with in assessment 1 (in the scenario below) and evaluate the evidence you locate, which could help to answer the question.

Introduction

PICO(T) is an acronym that helps researchers and practitioners define aspects of a potential study or investigation.

It stands for:

• P – Patient/population/problem.
• I – Intervention.
• C – Comparison (of potential interventions, typically).
• O – Outcome(s).
• T – Time frame (if the time frame is relevant).

The end goal of applying PICO(T) is to develop a question that can help guide the search for evidence (Boswell & Cannon, 2015). From this perspective, a PICO(T) question can be a valuable starting point for nurses who are starting to apply an evidence-based model or EBPs. By taking the time to precisely define the areas in which the nurse will be looking for evidence, searches become more efficient and effective. Essentially, by precisely defining the types of evidence within specific areas, the nurse will be more likely to discover relevant and useful evidence during their search. When applying the PICO(T) approach, the nurse can isolate the interventions of interest and compare them to other existing interventions for the evidenced impact on the outcome of the concern.