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Assignment on appraise the validity, relevance and applicability of the research evidence to the clinical question.

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Assignment on appraise the validity, relevance and applicability of the research evidence to the clinical question.

For my group’s research project, our PICOT question was “Do diabetic women of all races ages 30-60 have a reduction of hemoglobin A1C level in a four month period with an education of healthy eating?” We chose this question because we believe that diabetes is a very serious issue that can have many complications if not managed properly, and we believe health education is a crucial step in symptom management. We chose women of all races ages 30-60 because it matched the population of one of our clinical sites for this semester, which is a center for women getting back on their feet called the Ashbury House. During our research, we found many articles that provided evidence for the idea that health education interventions could in fact reduce HbA1c levels in patients with type 2 diabetes, which is the central argument for our project.

In an article by Haimoto et al. (2014), a quantitative study was done to research whether carbohydrate restriction changed the level of HbA1c in patients over a 6-month period. The study was performed on 122 outpatients with type 2 Diabetes Mellitus. Each patient’s HbA1c level and BMI were taken before and after the study. From the study, Haimoto et al. (2014), were able to conclude that the greater the reduction in carbohydrate intake, the greater the decrease in HbA1c levels. Another article that helped prove the benefits of knowledge of healthy eating in improving a person’s diabetes symptoms is one by Strychar et al. (2012). A quantitative systematic review was performed on 59 articles obtained through PubMed. The review focused on the effects that education had on the BMI and HbA1c levels of patients that underwent these educational programs. Strychar et al. (2012) were able to conclude that education of self-efficiency improved glycemic control over time. In an article by Willig et al. (2014), a qualitative study was performed on 35 women. Each woman was given an intuitive eating program and was tested for her glycemic control. The study concluded that intuitive eating programs were able to enhance the women’s glycemic control. These studies together provide evidence that education on healthy eating can play a big role in maintaining a patient’s diabetes. From teaching about the importance of reducing carbohydrate intake to providing a simple intuitive program about healthy eating, we can drastically improve a patient’s diabetes (specifically in terms of health markers such as HbA1c) through education of healthy eating.

                In an article by Taplin & Allen (2013), a quantitative retrospective pre-post intervention with control study was done in order to gauge the effect of diabetes education itself on the reduction of HbA1c levels. The study was done on 68 diabetic subjects, some of which were given a diabetes education program. The results showed that diabetes education was clinically significant in reducing HbA1c levels as compared to the control group. Another article that researched the effect of diabetes education on diabetes health markers was written by Gulli et al. (2014). They conducted a study on 30 patients with type 2 diabetes to determine whether a health education intervention would have an effect on the patients’ BMI, fasting blood glucose, HbA1c, and insulin treatment. They were able to conclude that health education intervention played a significant role in improving these health markers for diabetes. In a study by Liu et al. (2014), a quantitative retrospective study was performed on 220 type 2 diabetic patients to determine whether diabetes education would lower HbA1c. From the results, they were able to conclude that diabetes education significantly reduced HbA1c levels. Lastly, in a study by Yuan et al. (2014), 76 patients with type 2 diabetes were placed into an intervention group, who received diabetes self-management education (DSME) or a control group who did not receive any education intervention. This study was interesting because it included more detailed information on the physiologic effect of educational intervention, such as atherosclerotic factors. From the results, Yuan et al. (2014) were able to conclude that educational intervention drastically improved blood pressure, metabolic markers, HbA1c, and blood glucose in patients with type 2 diabetes. These articles contribute to the PICOT question because they show how important education is in improving a patient’s diabetes. A simple educational program can go a long way in improving these patients’ health.

                One last article that we wanted to point out described 15 articles that made several recommendations for educational interventions that could improve a patient’s diabetes symptoms. In the article, Maez et al. (2014) described how nutritional patient education, motivational counseling, and lifestyle modifications were found to be the most influential factors for improving the health status of a patient with type 2 diabetes. This was an important article because it provides a little more recommendation about what should be included in health education intervention in order to most effectively help a person with type 2 diabetes maintain their health.

                What I found the most significant through our research was the overwhelming evidence that was available that proved how something as simple as health education could drastically improve a patient’s HbA1c level. Each article concluded that health education could decrease the health markers for diabetes, such as HbA1c, blood glucose, BMI, etc. I think we are able to conclude through our research that health education would be an effective way for reducing the HbA1c levels in diabetic women of all races ages 30-60.

                Based off of this evidence, our group was able to make several recommendations for applying these interventions into clinical practice. First, we recommend that the clients enter a focus group program for the health education intervention in relation to their diabetes. In order to best gauge how well the patients are receiving and retaining the information, we could set up pre and post-tests to ensure their learning. We believe a focus group would be the best environment as it can set up a more motivational environment while still having an educational aspect, which is what Maez et al. (2014) concluded was the most influential factor for effective health education. Second, we recommend that a patient who is having difficulty adhering to the program be referred to a dietician. We wouldn’t want to direct our patients directly to one-on-one assistance with a dietician, as it is more costly; but if needed, it is something that we as nurses should consider recommending to our patients. One last recommendation would be for the patient to keep diet diaries. Diet diaries were something that several of the studies pointed out to be a crucial part of the health education intervention, and keeping one could really help a client keep up and monitor their intake to ensure that they stay at a healthy level.

                In conclusion, diabetes is a disease

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