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PICO (T) stands for patient intervention, comparison outcome, and time. The PICOT process begins with a situational question and a case scenario. This study describes a problem in practice involving patients who suffer from depression and anxiety and the implementation of PICO(T). This work will answer the research question by identifying evidence sources, evaluating the key findings of research articles NURS FPX 4030 Assessment 3, and assessing the relevance of the findings.
Depression or anxiety is a practice problem described as a persistent feeling of despair or a loss of interest in activity. This can interfere with sleep or appetite. Tiredness and lack of attention are also symptoms. More than 4 percent worldwide, including both young and older people, are affected by depression. Depression affects more than 200 million people worldwide. Depression is different from normal emotional reactions or mood swings. Depressions that are frequent and intense can lead to serious health complications. This causes the person to suffer and be unable to do their best at work or home. It can even lead to death in some cases. Over half a billion people have left this earth through suicide. Suicide is the leading cause of death among individuals aged 14-30 (Khubchandani et al., 2021).
Nurses need to have the professional skills and abilities necessary to manage patients who suffer from depression. The nurses also perform interventions and activities that help obese patients. This leads to the following practice question: For patients with depression or anxiety, integrated therapies (CBT with drugs) (I) are more effective than using a single intervention for depression reduction (O) within three months (T). Patient-centered care is the identified intervention strategy. It focuses on the individual’s experience and understanding of their needs rather than simply adopting healthcare providers’ skills (Cardel et al., 2022). The first step in this case is to identify and assess the patient’s demographics, daily routines, and nutrition. The intervention includes a wide range of therapies and treatments used by nurses and healthcare professionals in the healthcare system.
PICO(T), a question about healthcare quality, was solved by the Iowa Model Revised. It is based on evidence and promotes quality. This research model was created in 1994 by a team of nurses at the University of Iowa Hospital and Clinics and College of Nursing.
The model, in the first step, identifies plausible reasons for change. It also identifies opportunities to advance excellence in healthcare by using an evidence-based method. In the second step, the purpose is stated clearly. To help the user focus and establish clear goals, the question or purpose should be expressed in a PICO structure (Population, Intervention, Comparison, Outcome). Next, determine if the problem is significant to the affected people. The patients or organization may perceive this differently. If the problem is urgent, the user will move on to the next stage. Next, you will need to create a team. All stakeholders involved in the change of practice are included on the team. Next, gather, evaluate, and synthesize evidence. This step involves creating a plan, implementing it, preparing clinicians, and advocating for adoption. The change must be maintained by involving stakeholders, integrating it into workflows, and reevaluating it as necessary. Finally, the findings must be evaluated and used as a guide to implementing similar practice changes in other institutions (Cullen et al., 2022).
Google Scholar, CINAHL, and Pubmed were all used to find relevant evidence. The American Journal of Psychology, Journal of Anxiety and Depression, and the European Journal of Depression were also included. The databases were limited to articles published in the last five-year period. The Iowa Model was selected for its advice on the PICO (T) question for various reasons. It is widely used because it is easy to use and can be applied to many project issues. It was also appealing to use a linear process that included intermittent feedback. The model was chosen because nurses developed it, and it is best suited for nurses to use.
Nurses use Cognitive behavioral therapy in this context. Depression can be treated with CBT or enhanced mindfulness-based Stress Reduction (MBSR). Also, it has been shown that pharmaceutical treatments effectively treat depression and anxiety. Researchers have recently shown that psychotherapies and pharmaceutical drugs can be used to treat depression. CBT is one of the most effective treatments. There are many versions. The two types of CBT are individual CBT and group (Karyotaki et al., 2021). The CBT sessions take place between the therapist and the client. The therapists try to help the client manage depression by focusing on their problems. A CBT session usually lasts between 6 and 20 minutes (Reavell et al., 2018).
The Cuijpers et al. The Cuijpers et al. This research relates to a comparison of psychotherapy combined with pharmacotherapy compared to either one alone. The researchers analyzed 101 trials with 11,910 patients. The primary outcome was treatment response (50 % improvement from baseline to endpoint). As potential moderators, chronic and treatment-resistant depressive disorders, as well as baseline depression severity, were examined. In the network meta-analysis, the combination treatment was superior to psychotherapy and pharmacotherapy in terms of getting a response after treatment. Counseling and medication were similar. For treatment-resistant depression, the findings were similar, and a combination between psychotherapy and medication seems to be best (Cuijpers and al.,2020).
Cuijpers and colleagues conducted 58 studies involving 9,301 patients. (2021). They conclude that medication and psychotherapy are equally effective in treating depression compared to care as usual. Combining psychotherapy with medication produces better results than using either one alone. The primary care treatment must be structured so that these therapies can be offered in response to the patient’s preferences and priorities (Cuijpers et al., 2021).
Furukawa and colleagues conducted 81 relevant studies (13 722 patients). (2021). They have assessed the vast network of psychotherapies and treatment options to address depression. Findings show that acute-phase therapy outperforms standard treatment and pill placebos. This is true even if maintenance psychotherapies do not follow the psychotherapies.
Zhou and colleagues conducted a meta-analysis of Placebo-controlled and head-to-head trials of sixteen antidepressants, seven psychotherapies, and five antidepressant-psychotherapy combinations. (2020). The standard criteria used in these studies was to treat children and adolescents with anxiety or depression disorders. There are many treatments available for those with severe depression symptoms. Research has shown that fluoxetine is a good treatment for depression symptoms.
Guidi & Fava (2020) conducted a meta-analysis of 93 studies. They evaluated the pharmacotherapy response with antidepressant medication. The preventive value of the sequential strategy is based on a reduction in residual symptoms or an increase in psychological well-being. According to this revised systematic review, the combination of antidepressant medications (ADM) and subsequent psychotherapy following the acute phase medication was associated with a reduced risk of relapse or recurring major depressive disorders (MDD).
The combination of the approaches proved to be more efficient than using them separately. The Cuijpers et al. The (2020) treatment was selected because, in the network meta-analysis, the combination treatment performed better than psychotherapy and pharmacotherapy on their own in terms of getting a response by the end of the treatment. Counseling and medication alone did not make a significant difference in depression. Psychotherapy combined with medicine is the best choice for people suffering from depression.
Cuijpers and al. chose the study because it compared medication and psychotherapy to standard treatment. It appears to be more effective at treating depression (2021). Psychotherapy and medication work better together than they do individually.
Furukawa and colleagues were selected for the same reason. (2021). They found that acute-phase psychotherapies performed better than standard treatment and pill placebo, even without maintenance psychotherapies. The Guidi & Fava (2020) study, which examined people’s response to acute-phase pharmacotherapy in combination with antidepressant medications, was chosen. The sequential strategy’s preventive value is based on the reduction of residual symptoms and an improvement in psychological well-being.
Zhou et. The reason for choosing Zhou et al. (2020) was that they used established criteria to diagnose and treat anxiety or depression in children and adolescents. The researchers stated that many treatment options are available for those with severe depression symptoms. Research has shown that fluoxetine is a good treatment for depression symptoms. This is the most reliable and credible source of all studies, providing a comprehensive review of all treatments.
NURS FPX 4030 Assessment 3 focuses on exploring leadership and management principles in nursing, preparing students for future leadership roles.
The assessment may include case studies, essays, or presentations that require students to demonstrate their understanding of leadership concepts.
This assessment aims to enhance nursing management’s leadership, communication, problem-solving, and decision-making skills.
The topics may be predetermined by the instructor or allow students to select a relevant leadership issue in nursing.
Review leadership theories and nursing management principles, and study real-life examples of successful nurse leaders.
Collaboration policies may vary. Some instructors may encourage group work to foster teamwork and communication skills.
Utilize academic journals, textbooks, reputable websites, and evidence-based sources to support your leadership analysis.
Assessments will be evaluated based on the depth of leadership analysis, application of theories, and communication effectiveness.
Assessment 3 prepares students to address leadership challenges and effectively manage nursing teams in natural healthcare settings.
NURS FPX 4030 Assessment 3 equips nursing students with essential leadership skills, contributing to their success as future nurse leaders.
It is essential to use CBT and pharmacotherapy techniques to treat depression or anxiety disorders. The PICO(T), which identifies sources of evidence, summarizes the results and shows the relevance of these results, was used to evaluate whether CBT and pharmacotherapy are more effective.