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Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the previous course assignments and the guidelines below.

Prepare this assignment as a 1,500-1,750-word paper using the instructor’s feedback from the previous course assignments and the guidelines below.

Research Critiques and PICOT Statement Final Draft NRS 433

The nursing profession is awash with many problems that hamper patient care. Nurses encounter these problems in routine practice and should be centrally involved in addressing them comprehensively. Typically, nurses use the evidence-based practice (EBP) approach to address practice problems. The EBP approach recommends sourcing evidence from current, peer-reviewed scholarly studies to guide practice change. Quantitative and qualitative studies are both used to inform decision-making. The purpose of this paper is to analyze quantitative and qualitative articles, and determine the link between the PICOT question, the research articles, and the nursing practice problem.

Nursing Practice Problem and PICOT Question

The nursing practice problem identified for exploration through a PICOT approach is nurse burnout. It is among the prevalent problems in nursing practice stemming from numerous factors such as job dissatisfaction, increased workload, frustrations, and personal stressors outside of work (Dos Santos, 2020). The effects of nurse burnout are far-reaching and regrettable. They include apathy, fatigue, distraction, and increased vulnerability to committing medication errors (Kwon et al., 2021). Nurse burnout also increases the turnover rate among nurses. Such effects are detrimental to patient care hence the need for interventions.

PICOT Question: Among intensive care unit (ICU) nurses (P), can practicing stress management techniques like resilience, mindfulness, and yoga (I) compared to not practicing (C) lower burnout rates by 50% (O) within six months (T)?

Background

Different research studies explore nurse burnout from different dimensions. Uchmanowicz et al. (2021) conducted qualitative research on the challenges that nurses experience when providing care in under-resourced settings. The primary premise is that rationing nursing care leads to professional burnout among nurses working in critical areas like cardiovascular settings. The article is significant to nursing since it elaborates on the cause-outcome connection of nurse burnout. Its purpose is to evaluate the link between rationing of nursing care and nurse burnout. The objective is to determine the impacts of nurse rationing guided by the research question of whether rationing of nursing care leads to professional burnout in nursing staff.

In a different qualitative study, Dos Santos (2020) explored the relationship between nurses’ stress, burnout, and reduced self-efficacy levels. They further examined the leading sources of stress and burnout among nursing professions. The primary problems being explored include stress and burnout as leading causes of low self-efficacy. Understanding the causes is instrumental to addressing nurse burnout. As a result, the article is significant to nursing since it provides relevant information that can be used to reduce nurse burnout to improve patient care outcomes. The article’s purpose is to enhance understanding of the causes of nurse burnout to help address the problem by addressing the causes. The research question is, “what are the sources of burnout and stress lowering self-efficacy and lead to an unbalanced patient ratio?”

The quantitative articles primarily evaluate the solutions to nurse burnout in health care settings. Elkady (2019) studied how mindfulness and resilience can help nurses manage burnout and improve overall performance. The main problem that the article addresses is nurse burnout and how it continues to hamper health care delivery. Elkady (2019) assessed the beneficial effects of resilience and mindfulness as strategies to improve nurses’ health and well-being to cope with nurse burnout. The article is significant to nursing since it provides solutions to a prevalent nursing problem. The study’s research question is “what is the impact of mindfulness and resilience on nurse burnout?” Both interventions can be implemented through a training program.

Diehl et al. (2021) examined effective interventions based on social, personal, and organizational resources for protecting nurses from nurse burnout. When solutions to burnout are known, nurses and nurse leaders can liaise and implement them effectively. The article is significant to nursing since it explores the different solutions that can be implemented to mitigate the damaging effect of nurse burnout. Diehl et al. (2021) studied the protective role of resources on the workload-nurse burnout association. They examined how workload interferes with nurses’ ability to provide optimal care and the buffering effects of various resources. The research question is, “is the relationship between workload and burnout among nurses and the role of personal, social and organizational resources in protecting these providers?”

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How the Articles Support the Nurse Practice Issue (Nurse Burnout)

The four articles will be used to answer the PICOT question since they provide the background, causes, effects, and effective solutions. They demonstrate how nurse burnout is a prevalent problem affecting care delivery and why it needs to be a priority area when addressing nursing problems. The articles further demonstrate the link between stress, burnout, and low self-efficacy among nurses. Issues such as workplace bullying, the lack of personal development and self-care opportunities, and dissatisfaction have been noted as the primary focus areas when nurse leaders and organizational management want to address nurse burnout (Dos Santos et al., 2020; Uchmanowicz et al., 2021). The different interventions proposed in the article can be used to mitigate nurse burnout and stress. They include mindfulness, resilience, and resources to minimize workload (Diehl et al., 2021; Elkady, 2019). The solutions can be implemented individually or jointly depending on the severity and causes of nurse burnout.

The interventions and comparison groups share many characteristics with the study group in the PICOT question. To compare outcomes, researchers use an intervention group receiving the treatment and compare outcomes with a control group not receiving the treatment. Data collection varies depending on whether the study is qualitative or quantitative. As proposed in the PICOT question, the intervention group will practice stress management through mindfulness, resilience, and yoga and the results compared to a control group not receiving any stress management skills. The objective is to compare findings to rationalize the effectiveness of the nurse burnout intervention method.

Method of Study

Researchers use different approaches to explore different nursing problems. Uchmanowicz (2021) used the cross-sectional design to investigate the link between rationing and professional burnout. Data were collected via surveys. Diehl et al. (2021) used the same approach (a national cross-sectional survey) to investigate the buffering role of resources on the workload-burnout association among nurses. Elkady (2019) used quantitative survey research to evaluate the effects of mindfulness and resilience on job burnout. Dos Santos et al. (2020) invited nursing professionals for a qualitative inquiry based on a snowball sampling strategy.

Each method has different benefits and limitations. Cross-sectional studies are quick, inexpensive, and easy to conduct (Wang & Cheng, 2020). Researchers can also use them to generate hypotheses for future research. However, cross-sectional studies can miss crucial information about changes over time since they observe individuals at one point in time. A quantitative survey is a highly effective method for collecting data about multiple variables, including the study subjects’ opinions, behaviors, and demographics. However, surveys often rely on self-reported data (Fryer & Nakao, 2020). Unlike surveys, a qualitative inquiry allows researchers to investigate a problem in more depth and detail. However, researchers cannot quantify subjects’ responses.

Results of Study

The articles have different results helping to understand nurse burnout and how to address it in more detail. Uchmanowicz et al. (2020) found that the leading components of nurse burnout include emotional exhaustion, job dissatisfaction, and depersonalization. In the other study, Dos Santos (2020) found that factors within the nurses’ environment play a significant role in increasing stress and burnout, reducing nurses’ self-efficacy. Such factors include workplace incivility, lack of personal development, and family stress. Elkady (2019) found resilience and mindfulness to be effective buffers against nurse burnout. According to Diehl et al. (2021), personal, organizational, and social resources can effectively reduce nurse burnout. Such resources include a good working team and workplace recognition programs.

These studies have huge implications in nursing practice. Firstly, nurse burnout is a significant problem in today’s practice and worsens progressively. The articles can be used to understand its causes, manifestations, and possible solutions. Secondly, nurse burnout is associated with adverse outcomes, including increased absenteeism, turnover intention, and job dissatisfaction (Kwon et al., 2021). Since these outcomes hamper patient care, the articles can be used to guide practice change to prevent and buffer the damaging effects of nurse burnout. Mindfulness, resilience, and using resources such as workplace teams have been proposed as effective intervention programs. The articles can guide nurses in selecting and applying appropriate methods to address nurse burnout.

Ethical Considerations

Ethics is crucial in nursing research to ensure that studies are free from ethical and legal accusations. Two main ethical considerations guide nursing research- informed consent and confidentiality. According to Manti and Licari (2018.), informed consent involves apprising participants about the study’s details, including the nature, risks, and benefits, to enable them to participate willingly. Confidentiality involves protecting private information and not sharing it with anyone without the subjects’ approval. The four studies adhered to the ethical principles of informed consent and confidentiality. All the participants were informed about the nature of the study, and those unwilling to participate were excluded. Information obtained from the research was also kept confidential, as promised.

Outcomes Comparison

As hypothesized in the PICOT question, the anticipated outcome is that nurse burnout will decrease in nurses practicing stress management in six months. The outcomes of the four articles compare to the anticipated outcomes of the PICOT question since they focus on eradicating burnout among nurses. Stress management strategies emphasized in the articles include resilience, mindfulness, and organizational resources such as teamwork and recognition programs (Diehl et al., 2021). Stress management will help regulate nurses’ moods, reduce anxiety, and help them focus mentally and physically on their work.

Proposed Evidence-Based Practice Change

The PICOT question links strongly with the research articles and the nursing practice problem (nurse burnout). The articles provide useful information to answer the PICOT question. Using the information provided, nurses can apply resilience, mindfulness, and organizational resources to prevent and cope with burnout. To enable nurses to apply these strategies effectively, resilience and mindfulness training for nurses is important. Through such training, nurses should be taught stress management skills, including mindfulness breathing and resilience tips such as self-care, exercises, and working in teams.

Conclusion

Nurse burnout is among the prevalent problems hampering patient care in nursing practice. Like many other problems, an evidence-based approach is highly effective in addressing the problem. As discussed in this paper, stress management techniques can be used to address burnout among nurses. Addressing the problem will be instrumental in reducing nurse turnover and optimizing health outcomes. A nurse training in stress management is crucial to empower nurses experiencing burnout or at risk of burnout.

References

Diehl, E., Rieger, S., Letzel, S., Schablon, A., Nienhaus, A., Escobar Pinzon, L. C., & Dietz, P. (2021). The relationship between workload and burnout among nurses: The buffering role of personal, social and organizational resources. PloS One, 16(1), e0245798. https://doi.org/10.1371/journal.

Dos Santos, L. M. (2020). Stress, burnout, and low self-efficacy of nursing professionals: A qualitative inquiry. Healthcare, 8(4): 424. https://doi.org/10.3390/healthcare8040424

Elkady, A. A. M. (2019). Mindfulness and resilience as predictors of job burnout among nurses in public hospitals. International Journal of Psycho-Educational Sciences, 8, 14-21. https://perrjournal.com/index.php/per journal/article/view/167

Fryer, L. K., & Nakao, K. (2020). The future of survey self-report: An experiment contrasting Likert, VAS, Slide, and Swipe Touch interfaces. Frontline Learning Research8(3), 10-25. https://doi.org/10.14786/flr.v8i3.501

Kwon, C. Y., Lee, B., Kwon, O. J., Kim, M. S., Sim, K. L., & Choi, Y. H. (2021). Emotional labor, burnout, medical error, and turnover intention among South Korean nursing staff in a university hospital setting. International Journal of Environmental Research and Public Health18(19), 10111. https://doi.org/10.3390/ijerph181910111

Manti, S., & Licari, A. (2018). How to obtain informed consent for research. Breathe (Sheffield, England)14(2), 145–152. https://doi.org/10.1183/20734735.001918

Uchmanowicz, I., Kubielas, G., Serzysko, B., Kołcz, A., Gurowiec, P., & Kolarczyk, E. (2021). Rationing of nursing care and professional burnout among nurses working in cardiovascular settings. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.726318

Wang, X., & Cheng, Z. (2020). Cross-sectional studies: strengths, weaknesses, and recommendations. Chest158(1), S65-S71. https://doi.org/10.1016/j.chest.2020.03.012

 

Postpartum depression remains a significant mental health problem for women who have recently delivered. Postpartum depression can result to increased risk for developing major depressive disorder in the later part of a patient’s life. Studies, both qualitative and quantitative, show that postpartum depression can lead to diminished interaction between the mother and a newborn child, the family and other members of community (Chaharrahifard et al., 2021). The purpose of this paper is to review the PICOT Statement, offer a critique of the articles and provide an evidence-based practice change and establish the link between the PICOT question, nursing problem, and research articles.

Nursing Practice Problem and PICOT Question

Nursing Practice Problem

Postpartum depression is a critical mental health issue that affects mother after delivery and may lead to negative impacts on their ability to breastfeed the newborns and their interactions. Studies show that about 15% of women experience psychological disorders before, during and after delivery and these may include depression, anxiety, and stress associated with pregnancy and child birth (Chaharrahifard et al., 2021). Symptoms of postpartum depression include insomnia, loss of appetite, difficulties in bonding with the newborn, and increases irritability. Untreated postpartum depression may last longer and lead to the use of different types of therapies like antidepressants to treat it and exacerbate the poor mental state of the new mother. Many of these women do not have access to effective mental health interventions like psychoeducation interventions that can help them mitigate the effects of postpartum depression. Postpartum psychoeducation assists these women to reduce adverse effects of their condition and improve their interactions with their newborns and families.

Quantitative and Quantitative Studies

PICOT Statement & Question

Population or Problem

Postpartum depression affects over 15% of women with many lacking access to better mental health interventions. Lack of treatment for postpartum depression can lead to negative effects like reduced interactions between the mother and the newborn and family members, especially the husband. Maternal postpartum depression a risk factor for developing paternal depression leading to communication breakdown that can heighten marital conflicts. It is vital to develop effective strategies that include psychoeducation as means of managing and preventing the condition

Intervention

The intervention proposed in this study is the use of psychoeducation for mothers suffering from postpartum depression as provided by nurses, especially psychiatric nurse practitioners dealing with such mothers. Psychoeducation assists women with the condition to reduce the adverse effects on mental health and improve their interactions with their newborns.

Comparison

The aforementioned intervention will be compared to the normal clinical routine (Treatment as Usual) where nurse practitioners do not integrate the use of psychoeducation as a tool to address mental health issues among the new mothers.

Outcome and Time

Through the integration of psychoeducation, the nurse practitioners aim at preventing the occurrence and prevalence of postpartum depression among the new mothers within six months.

PICOT Question

Among the mothers who have newly given birth (P), what is the efficacy of psychoeducation (I) in comparison to normal clinical routine (C) in preventing the development of postpartum depression (O) within six-month study period (T)?

Background

The project considers four main articles, both qualitative and quantitative, to discuss the background to the clinical problem presented. The two qualitative articles include one by Lackie et al. (2021) titled “Digital Health Needs of Women with Postpartum Depress: Focus Group Study. The objective of this study is the evaluation of unfulfilled psychoeducational needs of mothers suffering from postpartum depression and determining the efficacy of web-based interventions to meet these needs. The article identifies postpartum depression among expectant mothers after delivery as the main problem and emphasizes how different patient experience the challenge. The study is significant to the nursing practice since it offers interventions to manage postpartum depression. The primary research question in the study is; what are some unfulfilled psychoeducation needs, and what is the efficacy of utilizing web-based interventions to meet the needs of mothers with postpartum depression.

The second qualitative article was by Lam and Ngai titled (2021) “Process of Evaluation of couple-based psych education program for first-time parents.” The primary objective of this study was to assess the benefits of utilizing couple-based psychoeducation intervention to manage postpartum depress and exploration of factors that impact the efficacy of the intervention. The problem in the study is linked to couple-based psychoeducation program for first-time parents. The study is essential to nursing as it offers unique approaches to helping individuals with postpartum depression by including their families. The main question in the study was, what are the benefits of having a couple-based psychoeducation intervention in managing postpartum depression for first-time parents.

The first quantitative article is by Derakhshanpour et al. (2020) titled “Effects of a psychoeducational intervention on Postpartum Health.” The study main problem is that women experience heightened levels of stress after delivery as a result of hormonal effects in their bodies. The study sought to know if psychoeducation can assist women reduce adverse effects of their condition on mental health and improve their interactions with their newborns and families. The study is significant to nursing since it offers strategies that can be applied to enhance management of postpartum depression. The second quantitative study is by Chan et al. (2018) which focuses on the utilization of smartphone-based psychoeducation interventions to reduce postnatal depression for first-time mothers. The study main purpose is to show that smartphone intervention alongside treatment as usual (TAU) strategies reduce postpartum depression for mothers after delivery compared to controlling the situation using routine strategies. The studies are significant to nursing practice as they show the need to integrate psychoeducation program as part of the preparation before and after delivery, especially for first-time mothers. The research question in the study was “can smartphone-based text messages be effective in reducing depression among newborn mothers?”

Four Article Supporting the Nurse Practice Issue

The four articles are critical to and support the nurse practice issue identified because of the evidence they offer based on their findings in different areas. For instance, both the qualitative articles identify strategies for managing postpartum depression and their benefits. The article by Lackie et al. (2021) and Chan et al. (2018) all demonstrate how web-based interventions can offer immense benefits in helping first-time mothers deal with postpartum depression. The second qualitative article relates to the PICOT as it explores the positive effects of psychoeducation intervention. The second quantitative article underscores the benefits of having better healthcare for new mothers and the need to prevent mental health conditions that may impair their ability to be effective mothers. The articles also demonstrate how nurse practitioners can leverage remote medical and health technology to enhance efficacy and reach out to patients to ensure that they do not encounter adverse conditions as they start their journeys as new mothers.

The interventions and comparison groups of the articles align with the nursing issue and the PICOT question. The two qualitative articles have a close correlation with the interventions identified in this study. The interventions by the articles offers a hypothetical approach to the issue and causal inference. The estimation of the outcomes of treatment is attained through a comparison of the articles with the PICOT question. More fundamentally, the interventions of the quantitative articles also show a close relationship between mental health status in postpartum time and efficacy of psychoeducational programs.

Method of Study

The four articles use different study methods based on their choice by their researchers and the phenomenon under study. The article by Derakhshanpour et al. (2020) uses randomized clinical trial while the article by Chan et al. (2018) deploys a blind randomized control trial. The implication is that both studies had control groups and researchers obtained data from self-reports and interviews by the participants. The study by Chan et al. (2018) used treatment as usual (TAU) alongside the intervention to evaluate the effects of the strategy. The qualitative studies also employ different methods with the first one using focus groups while the second one using descriptive approach. The implication is that both studies are qualitative implying that they use secondary data to draw conclusion and answer the research questions.

Randomized control studies have benefits that include minimization of bias. Conversely, the applicability of the results can be challenging and should always be tested for their effectiveness. Randomized control trials are also expensive and require more participants to carry out. Focus groups offer a host of benefits that include understanding the feelings and attitudes of participants. They also have clarity of any preconceived notion from the respondents. However, they are expensive to organize and implement. Descriptive studies are easy to carry out because they do not entail comprehensive measures. Conversely, they may be limited by lack of accurate outcomes in the process of interviewing participants.

Results of the Study

The four articles make important findings about nursing issue of postpartum depression and the impacts of psychoeducation in addressing the challenge. The study by Lackie et al. (2021) identifies five themes in addressing the issue that include customization to enhance relevance, individual empowerment in owning their mental health and meeting needs by bridging any gaps. The second study by Lam and Ngai (2021) shows that the intervention is efficacious with different factors helping to facilitate it like reinforcement, follow-ups and having it during non-working hours.

The study by Chan et al. (2018) shows positive link between the intervention and depression reduction. The research by Derakhshanpour et al. (2020) shows that psychoeducation intervention mitigates postpartum depression. The implication is that victims of postpartum depression need social support to embrace their new roles and circumstances. The studies demonstrate that having psychoeducational programs help reduce depression and allow mothers to provide better care to their newborns. The studies are beneficial to the nursing practice as they enhance knowledge and use of practical intervention to help new mothers adjust to their new roles. The studies facilitate new knowledge in nursing and offer guidelines to help reduce further health complications among mothers with postpartum depression.

Ethical Considerations

Informed consent and confidentiality of information are essential in research. The articles demonstrate that the researchers kept ethical guidelines and participants were informed of their rights and obligations. Researchers should maintain the privacy of information and ensure that only interested parties are permitted to access the data. Participants need to understanding their rights and offer informed consent based on the information from the researchers.

Outcomes Comparison

The PICOT question’s expected outcome entails reducing the postpartum depression by effective education, enhanced participation of nurse practitioners and assisting new mothers understand their roles and improve the care of their newborns. The PICOT question’s main focus is to combine the normal routine interventions with new approaches like psychoeducation to reduce postpartum depression among mothers.

The outcomes of the four articles compare to the anticipated outcomes favorably as the PICOT question focuses on integration of different interventions alongside the standard practices to enhance mental health of newly delivered mothers and their newborns. All the articles show that effective interventions like psychoeducation can help reduce chances of postpartum depression among the mothers.  Therefore, the articles align with the expected outcomes from this project as they show that integration of different interventions is critical in attaining quality mental health outcomes for the affected women.

Proposed Evidence-Based Practice Change

The PICOT question, the research articles and the nursing practice issue of postpartum depression are linked. The PICOT question seeks to understand if these interventions can result into quality mental health status after delivery while the research articles offer current literature and research findings on the issue. The nursing issue of postpartum depression is at the center of these interventions as practitioners seek ways to reduce the problem through practical solutions.

The proposed evidence-based practice change to the setting is to ensure that nurse practitioners and other stakeholders integrate practical tools and strategies like the use of psychoeducational programs to enhance mental wellbeing of new mothers in the practice. Through psychoeducational initiatives, the facility will help many new mothers have better mental health by reducing the effects of postpartum depression (Martín-Gómez et al., 2020). The intervention will lead to better patient experience and interactions with the newborns and even families.

Conclusion

Postpartum depression remains a critical challenge to many expectant and new-delivered mothers. Nurse practitioners should develop responsive interventions like the use of psychoeducational approaches to enhance mental health of the affected mothers and help them reduce adverse events like depressive disorders. The project shows that nurse practitioners can use psychoeducation program as a tool to enhance quality care delivery for mothers with newborns.

 

References

Chaharrahifard, L., Motlagh, A. J., Akbari-Kamrani, M., Ataee, M., & Esmaelzadeh–Saeieh, S.

(2021). The Effect of Midwife-led Psycho-Education on Parental Stress, Postpartum Depression and Parental Competency in High-Risk Pregnancy Women: A Randomized Controlled Trial. Journal of Caring Sciences, 10(2), 70-76. Doi: https://doi.org/10.34172/jcs.2021.014

Chan, K. L., Leung, W. C., Tiwari, A., Or, K. L., & Ip, P. (2019). Using smartphone-based

psychoeducation to reduce postnatal depression among first-time mothers: Randomized controlled trial. JMIR mHealth and uHealth, 7(5), e12794. https://preprints.jmir.org/preprint/12794.

Derakhshanpour, F., Kashani, L., Taghavi, S., Salimi, Z., & Shahini, N. (2020). Effect of a

Psychoeducation Intervention on Postpartum Health. Journal of Clinical and Basic Research, 4(4), 8-16. 10.52547/jcbr.4.4.8

Lackie, M. E., Parrilla, J. S., Lavery, B. M., Kennedy, A. L., Ryan, D., Shulman, B., & Brotto, L.

  1. (2021). Digital Health Needs of Women With Postpartum Depression: Focus Group Study. Journal of Medical Internet Research, 23(1), e18934. DOI: 10.2196/18934

Lam, W., & Ngai, F. W. (2021). Process evaluation of couple‐based psychoeducation program

for first‐time parents. Journal of Evaluation in Clinical Practice.  https://doi.org/10.1111/jep.13543

Martín-Gómez, C., Moreno-Peral, P., Bellón, J. A., Cerón, S. C., Campos-Paino, H., Gómez-

Gómez, I., … & Motrico, E. (2020). Effectiveness of psychological, psychoeducational and psychosocial interventions to prevent postpartum depression in adolescent and adult mothers: study protocol for a systematic review and meta-analysis of randomised controlled trials. BMJ open, 10(5), e034424. doi.org/10.1136/bmjopen-2019-034424