Nursing Problem and PICOT Question
The problem of diabetes being one of the most common and dangerous health concerns in the American population has been on the agenda of healthcare services for a while. Nonetheless, the issue of diabetes and the comorbid health concerns remains a common problem in healthcare. Specifically, a significant number of patients with diabetes are particularly prone to developing kidney diseases, particularly, diabetic nephropathy, due to the damage to blood vessels in kidneys (Alotaibi et al., 2016). As a result, the kidneys fail to filter blood, causing a significant kidney damage (Shiyanbola et al., 2018). The described issue affects the African American population especially strongly due to a range of factors, the lack of resources for health management and health literacy being the key ones (Kaya & Karaca, 2018). This paper seeks to answer the following PICOT question: In African-Americans with diabetes, does education about this disease, lifestyle, and medications affect the probability of developing kidney disease when compared to no education, in one week?
Background of Studies
Each of the studies under analysis introduces a unique outlook on the issue at hand. For instance, the study by Keddis et al. (2019) defines the lack of education about kidney transplants in diabetic patients as a crucial health issue. Aiming at defining the perceptions and attitudes of the target population, the study serves as an important proof that patients lack education about kidney issues drastically. Likewise, the study by Shiyanbola et al. (2018) outlines problems in the perception of diabetes and the associated disorders in African American people, stating that changing the perception of diabetes in the target population will cause an increase in the efficacy of care. In turn, the papers by Alotaibi et al. (2016) and Kaya et al. (2018) point directly to the absence of proper knowledge in nurses as the main source of concern.
Method of Studies
The six studies selected for this paper represent the qualitative (Keddis et al., 2019; Shiyanbola et al., 2018) and quantitative (Kaya & Karaca, 2018; Alotaibi et al., 2016) research methods respectively. The key conceptual theoretical frameworks utilized in the studies under analysis provide a clear insight into the issue at hand. Specifically, the application of a thematic analysis and systematic review is consistently used throughout the qualitative frameworks. In turn, the quantitative studies feature the approaches such as the randomized controlled trial. Thus, the goals of each study are addressed respectively.
Results of Studies
Remarkably, most of the studies under analysis have demonstrated the drastic lack of awareness concerning the issue of possible kidney failure in diabetic patients not only within the vulnerable group, but also among nurses. Specifically, the paper by Alotaibi et al. (2016) proves that there is a significant knowledge gap among nurses concerning the issue of kidney disease in patients with diabetes, whereas the paper by Kaya and Karaca (2018) states that there is an urgent need for an appropriate intervention aimed at building the levels of competency among nurses. However, the existing qualitative studies on the subject at hand have also shown the drastic lack of health literacy among patients (Kaya & Karaca, 2018). Another research has suggested that the frameworks such as the common sense model could be utilized to enhance the levels of awareness among patients (Shiyanbola et al., 2018). Finally, the available evidence points to the absence of clear policies and coherent guidelines for nurses to promote patient education regarding the threat of kidney disease, as well as standards for competency in the specified task for nurses (Keddis et al., 2019). Therefore, it is crucial to revisit the present policies for managing health literacy in African American patients with diabetes, as well as encourage the development of skills for patient education in nurses respectively.
Arguably, the changes observed throughout a week could be regarded as not quite sufficient for making long-lasting conclusions regarding the role of patient education in reducing the development of kidney disease in patients. Indeed, to test the proposed type of intervention, its efficacy, and its possible limitations, a more lengthy study will be required. Thus, the paradigm for addressing the needs of African American patients with diabetes and predisposition toward kidney disease will be structured as a cohesive approach that can be applied to various settings.
Given the fact that the absence of a coherent and adequate approach toward patient education for people with diabetes concerning kidney disease and failure is one of the essential factors contributing to the rise in the threat, establishing an education paradigm is strongly recommended. Namely, the existing studies demonstrate that there is a noticeable lack in crucial skills for promoting education among nurses. Moreover, the extent of knowledge concerning diabetes, its outcomes, and comorbid conditions appear to vary substantially depending on the country and the quality of education. Therefore, it is vital to encourage change in the current framework for promoting patient and nurse education concerning the issue of kidney failure in African American people with diabetes.
PICOT Question, Research Articles, and Nursing Practice Problem Relationship
The available studies on the subject matter indicate several problems with the current approach toward managing the threat of kidney failure in patients with diabetes. The lack of an adequate approach to patient education and the ability to communicate essential information to patients about their critical condition is one of the foundational contributors to the rise in exposure to kidney disease among diabetic patients, as the research by Keddis et al. (2019) states. Therefore, it is critical to promote education both for nurses and for patient so that a powerful communication channel for maintaining the well-being of the target population could be created. Thus, nurses will be able to provide critical instructions to patients while continuing professional training and developing the necessary skills for tending to the needs of the target audience effectively.
The issue of the lack of education concerning the subject matter among nurses is another factor that could be represented as an essential contributor to the current situation. Specifically, Alotaibi et al. (2016) establish with sufficient proof and authority in their research that nurses presently lack the competencies needed to perform the necessary intervention for preventing kidney disease in diabetic patients. The described observation indicates that the identified problem of patient education exists and needs to be addressed urgently. Moreover, the article allows expanding upon the PICOT question, referencing not only one of it variables, namely, the lack of education, but also the fact that the described issue concerns nurses in equal part to patients. Therefore, Alotaibi et al.’s (2016) study not only confirms the presence of an ongoing health issue, but also broadens the scope of the problem, indicating that the process of education needs to start with training the nursing staff and redefining the current guidelines for addressing the needs of African American patients with diabetes.
In turn, the study by Kaya and Karaca (2018) allows delving even deeper into the problem of education and awareness of kidney disease issues in diabetic patients. Specifically, apart from pointing to the necessity to reintroduce a framework for nurse education and revisit the current guidelines for preventing kidney failure in patients with diabetes, the article also encourages introducing tools for measuring nurses’ current knowledge. Therefore, the issue of kidney disease prevention in African American patients gains greater depth and more insight as the article shows the importance of education for both patients and nurses, with the focus on continuous learning for both being positioned as a priority.
Furthermore, the existing qualitative studies also show the importance of educating patients while also supporting the increase in nurses’ experience and competency level. Particularly, the study by Kaya and Karaca (2018) establishes that patients’ lack of awareness and understanding of the significance of the issue, as well as the inability to spot main symptoms of a kidney disease immediately and address healthcare services, remains one of the contributing factors to the rise in the death toll among people with diabetes. Moreover, according to Keddis et al. (2019), the observed trend has become particularly worthy of concern in African American communities, mostly due to the unavailability of appropriate healthcare resources. Additionally, the presence of a denial in patients with diabetes represents one of the foundational hindrances to the timely and successful management of a kidney disease.
However, the proposed time frame is quite sufficient for determining major obstacles toward patient education and the efficacy of strategies proposed for altering patients’ attitudes toward the threat of kidney failure. Specifically, the use of innovative IT and ICT tools for controlling data management and reinforcing the quality of nurse-patient communication is believed to support the research and lead to robust results. Therefore, while the described study will be performed within a comparatively small time frame, it is believed to produce the required effect, namely, proving that the focus on patient education will allow reducing the level of threat of kidney disease for African American diabetic patients.
Proposed Evidence-Based Change
By introducing available educational resources and reinforcing the connection between a patient and a nurse educator, one can ensure that the process of building health literacy in African American patients with diabetes increases, thus reducing the that of developing kidney disease in them. As the results of the analysis have shown, the introduction of available tools and resources for building health literacy and reducing the influence of health myths on the target demographics’ decision-making allows minimizing the exposure to risk factors leading to the development of diabetic nephropathy. Therefore, it is strongly encouraged to build additional communication channels that will help to extent health support to the African American community and promote active education. By providing African American patients with diabetes with the necessary resources and information concerning diabetes and the associated threat of the kidney disease, as well as guidelines for minimizing the related risks, one will be able to reduce the threat of African American patients with diabetes suffering kidney damage as a result of v or a similar health issue.
Alotaibi, A., Al-Ganmi, A., Gholizadeh, L., & Perry, L. (2016). Diabetes knowledge of nurses in different countries: An integrative review. Nurse Education Today, 39, pp. 32-49. Web.
Kaya, Z., & Karaca, A. (2018). Evaluation of nurses’ knowledge levels of diabetic foot care management. Nursing Research and Practice, 2018, pp. 1-12. Web.
Keddis, M., Finnie, D., & Kim, W. S. (2019). Native American patients’ perception and attitude about kidney transplant: A qualitative assessment of patients presenting for kidney transplant evaluation. BMJ Open, 9(1), 1-7. Web.
Shiyanbola, O. O., Ward, E. C., & Brown, C. M. (2018). Utilizing the common sense model to explore African Americans’ perception of type 2 diabetes: A qualitative study. PloS One, 13(11), 1-22. Web.