In this week’s discussion question you were asked to consider a potential problem (appropriate to your role option) that you would like to investigate through nursing research. For this assignment you will review current research from South’s Online Library and provide a critical evaluation on that research through an annotated bibliography. An annotated bibliography is a brief summary and analysis of the journal article reviewed. For more information on annotated bibliographies please visit Purdue’s OWL: https://owl.english.purdue.edu/owl/resource/614/01/
A total of four annotated bibliographies are to be submitted (not to exceed one page each). The articles must come from nursing scholarly literature and may not be older than 5 years since publication. Please note that the articles must be research based and reflect a quantitative methodology (review our reading assignments). Web pages, magazines, textbooks, and other books are not acceptable.
Each annotation must address the following critical elements:
|Assignment 3 Grading Criteria||Maximum Points|
|Articles selected are appropriate to role option and support the potential problem identified.||20|
|Addresses required elements for each of the 4 nursing research articles that provide supportive evidence for the problem.||40|
|Articles selected meet guidelines (quantitative methodology, nursing scholarly literature, no older than 5 years since publication).||30|
|Followed APA guidelines for writing style, format, spelling, and grammar.||10|
** My submitted discussion and bibliography, choose 4 for the assignment:
Diabetes has achieved epidemic levels in the US, making effective management a high priority in the health care system struggling to simultaneously enhance care and lower cost. Family nurse practitioners (FNPs), which is my nursing specialty, have become much more aware of the significance of this preventable epidemic and have the fundamental knowledge, insight and resources to help diagnosis, treat and manage patients that are at risk of being diagnosed with diabetes or already have it. My reason for researching diabetes is because there still continues to be a major communication gap between patients and FNPs on the overall treatment and management of diabetes and its related medical conditions. The need for FNPs to educate diabetes patient on self-management strategies is imperative. However, it appears that many FNPs educate diabetes patients in one fashion. The problem with this is that each patient has a different cultural background, so FNPs need to tailor diabetes self-management strategies/plans that are going to be effective based on the patients cultural background.
My library research strategy for this project is to examine multiple databases, such as the National Library of Medicine, the National Institutes of Health, and PubMed, Society for Biomedical Diabetes Research, as well as government agencies and professional nursing organizations that have reported the most up-to-date evidence-based practices for diabetes research. In doing so, I must utilize search terms that are relevant to diabetes. Some of these identifiable concept search terms include (but not limited to) blood glucose, diabetes, diabetes mellitus, type-1 and type-2, hemoglobin A1C, hyperglycemia, and insulin; just to name a few.
According the 2014 National Diabetes Statistics Report, there are 29.1 million individuals in the United States that have diabetes, of which 21 million of the total individuals have been diagnosed with diabetes and the remainder, 8.1 million individuals are either underdiagnosed or have not been diagnosed as of yet (CDC, 2014). This statistics are alarming, to say the very least.
Provider-patient self-care communication is fundamental to enhancing patient adherence, yet various boundaries exist that undermine successful healthcare provider-patient self-care communication. From the health care professional point of view, the most regularly referred to barrier to self-care communication is time. Researchers, Bundesmann & Kaplowitz (2011), conducted a study of family medicine practices found that the time physicians went through talking about self-care with their patients shifted from 1 to 17 minutes, proposing that time is a noteworthy obstruction to self-care correspondence. Different obstructions incorporate absence of joint effort and cooperation among healthcare professionals, absence of patients’ access to resources, and lack of psychosocial support for patients with diabetes (Bundesmann & Kaplowitz, 2011). Relatedly, Beverly and associates found that doctors frequently feel deficiently prepared to address diabetes patients’ psychosocial issues and this apparent absence of aptitude may add to doctors feeling overpowered and disappointed inside the provider–patient relationship, which may hinder open self-care correspondence ((Beverly et al., 2011).
From the patient’s perspective of self-care diabetes communication, boundaries have a tendency to vary from those apparent by healthcare providers. In one subjective review with healthcare providers and patients, both noticed that patients were hesitant to discuss self-care for the fear of being judged or disgraced about food intake and weight (Ritholz, Beverly, Brooks, Abrahamson, & Weinger, 2014). This finding was bolstered in a quantitative follow-up study surveying patient hesitance to talk about self-care. According to the article, 30% of studied patients reported hesitance to examining self-care with their healthcare providers because of a paranoid fear of being judged, not having any desire to frustrate their provider, guilt, and shame (Beverly et al., 2012).
Diabetes self-management is a key element in the overall management of diabetes. Identifying barriers to disease self-management is a critical step in achieving optimal health outcomes. According to Holt and his fellow colleagues, they explained that knowledge of the pathophysiology and pharmacology of diabetes structures the establishment of care. It encourages composing scripts and observing substance changes, however this information alone is not adequate (2013). A fundamental comprehension of the social and psychological parts of diabetes care is likewise required. Care that does include acknowledgment and comprehension of these parts of the disease prompts to dissatisfaction, outrage, frustration, weakness, disruption, and burnout for both the healthcare provider and the patient. This prompts to a feeling of disappointment and the additional barrier of “idleness” (Holt et al., 2013). The healthcare provider, patient, or both feel that there is no hope and pass on that sense through activities, words, and nonverbal conduct. However, in another article from Shrivastava, Shrivastava, & Ramasamy (2013), they determined that socio-demographic and cultural boundaries have been barriers to why diabetes patient lack self-care management strategies. As one can clearly see from the literature above, there are varying barriers that comprise the communications between providers and patients when it comes to diabetes self-care management.
One solution to this problematic issue would be to implement a psychoeducational training program that would educate healthcare providers on being more culturally competent and to teach them various techniques for motivational interviewing of patients with diabetes.
Beverly, E. A., Ganda, O. P., Ritholz, M. D., Lee, Y., Brooks, K. M., Lewis-Schroeder, N. F., Weinger, K. (2012). Look Who’s (Not) Talking: Diabetic patients’ willingness to discuss self-care with physicians. Diabetes Care, 35(7), 1466-1472. doi:10.2337/dc11-2422
Beverly, E. A., Hultgren, B. A., Brooks, K. M., Ritholz, M. D., Abrahamson, M. J., & Weinger, K. (2011). Understanding Physicians’ Challenges When Treating Type 2 Diabetic Patients’ Social and Emotional Difficulties: A qualitative study. Diabetes Care, 34(5), 1086-1088. doi:10.2337/dc10-2298
Bundesmann, R., & Kaplowitz, S. A. (2011). Provider communication and patient participation in diabetes self-care. Patient Education and Counseling, 85(2), 143-147. doi:10.1016/j.pec.2010.09.025
CDC. (2015). 2014 Statistics Report | Data & Statistics | Diabetes | CDC. Retrieved from https://www.cdc.gov/diabetes/data/statistics/2014s…
Holt, R. I., Nicolucci, A., Kovacs Burns, K., Escalante, M., Forbes, A., & Hermanns, N. (2013). Diabetes Attitudes, Wishes and Needs second study (DAWN2™): Cross-national comparisons on barriers and resources for optimal care-healthcare professional perspective. Diabetic Medicine, 30(7), 789-798. doi:10.1111/dme.12242
Ritholz, M. D., Beverly, E. A., Brooks, K. M., Abrahamson, M. J., & Weinger, K. (2014). Barriers and facilitators to self-care communication during medical appointments in the United States for adults with type 2 diabetes. Chronic Illness, 10(4), 303-313. doi:10.1177/1742395314525647
Shrivastava, S., Shrivastava, P., & Ramasamy, J. (2013). Role of self-care in management of diabetes mellitus. Journal of Diabetes & Metabolic Disorders, 12(1), 14. doi:10.1186/2251-6581-12-14