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Topic:

PICO Analysis of Dementia, Delirium, and Depression

Coursework Instructions:

Assignment: Application – PICO Analysis of Dementia, Delirium, and Depression
A PICO analysis is used to pose a focused clinical question to which you find appropriate evidence-based answers. The PICO question should include the patient or population (P), anticipated intervention (I), comparison group or current standard (C), and outcome desired (O). In this Assignment, you develop a question related to dementia, delirium, or depression. Through your PICO analysis, you explore various resources and examine current evidence to answer the question you develop.
To prepare:
Select one of the following disorders as your topic: dementia, delirium, or depression.
Review the guidelines in the “Literature Review Matrix” document in this week’s Learning Resources.
Think about a research question around your issue as indicated in Part I: PICO Analysis of Research Topic.
Consider the resources you will use, search terms and criteria, and Boolean search strings as indicated in Part II: Search Strategy.
Using the Walden Library and other appropriate databases, locate five articles related to your PICO question. At least one article must be a systematic review. All of the articles should be primary sources.
Reflect on the five articles you selected as indicated in Part III: Analysis of Literature. Consider the conceptual framework/theory, main finding, research method, strengths of study, weaknesses, and level of evidence for each article.
Consider how to use the summaries in Part III to create an evidence table. Use this evidence table to determine appropriate treatment options for patients who present with the disorder you selected as your topic.
To complete:
Formulate a question around the disorder you selected as indicated in Part I: PICO Analysis of Research Topic.
Identify the resources you will use, search terms and criteria, and Boolean search strings as indicated in Part II: Search Strategy.
Summarize the five articles you selected as indicated in Part III: Analysis of Literature. Describe the conceptual framework/theory, main finding, research method, strengths of study, weaknesses, and level of evidence for each article.
Create an evidence table based on the article summaries in Part III. Describe appropriate treatment options for patients based on this evidence table.
Resource:
Resnick, B. (Ed.). (2019). Geriatric nursing review syllabus: A core curriculum in advanced practice geriatric nursing (6th ed.). New York, NY: American Geriatrics Society.

• Chapter 37, “Dementia” (pp. 272-283)
This chapter examines the epidemiology and societal impact of dementia. It also presents guidelines for assessing, diagnosing, treating, and managing dementia in addition to providing pharmacologic and nonpharmacologic treatment options.

• Chapter 38, “Behavioral Problems in Dementia” (pp. 284-293)
This chapter explores clinical features of behavioral and psychologic symptoms related to dementia, as well as guidelines for assessment, differential diagnosis, and treatment. It also examines treatment for mood disturbances, manic-like behaviors, delusions and hallucinations, disturbances of sleep, hypersexuality, and intermittent aggression or agitation.

• Chapter 39, “Delirium” (pp. 294-303)
This chapter explores the spectrum of delirium, including the incidence and prognosis, risk factors, and diagnostic criteria for delirium. It also presents guidelines for diagnosing, treating, and managing patients with delirium, including pharmacologic therapy and drugs to reduce or eliminate as part of delirium management.

• Chapter 41, “Depression and Other Mood Disorders” (pp. 316-324)
This chapter explores treatment strategies for depression and other mood disorders affecting older adults. It examines types of pharmacotherapy, antidepressants, as well as other treatment options, such as electroconvulsive therapy and psychosocial interventions.
Holroyd-Leduc, J., & Reddy, M. (Eds.). (2012). Evidence-based geriatric medicine: A practical clinical guide. Hoboken, NJ: Blackwell Publishing.

• Chapter 6, “Clarifying Confusion: Preventing and Managing Delirium” (pp. 65–72)
This chapter examines strategies for screening, prevention, and management of delirium among older adults in hospital settings.

• Chapter 7, “Preserving the Memories: Managing Dementia” (pp. 73–93)
This chapter examines dementia risk factors and screening tools for dementia. It also presents strategies for managing patients with dementia, focusing on pharmacological and nonpharmacological treatments.

• Chapter 8, “Enjoying the Golden Years: Diagnosing and Treating Depression” (pp. 94–104)
This chapter defines depression and identifies causes and risk factors that make older adults more susceptible to depression. It also examines treatment options for managing older adults with depression.
Document: Literature Review Matrix (Word document)
Required Media
Alzheimer’s Association. (n.d.). Inside the brain: A tour of how the mind works [Multimedia file]. Retrieved August 1, 2014, from http://www(dot)alz(dot)org/braintour/3_main_parts.asp

This website provides an overview of the structure and function of the brain and explores how Alzheimer’s disease changes the brain.

 

Part I: PICO Analysis of Research Topic

 

P: Patient or Population

 

I: Anticipated Intervention

 

C: Comparison group or Current standard

 

O: Outcome desired

 

Source: Adapted from Elkins (2010)

 

Step 1: Frame your clinical question using the PICO method.

 

P:

 

I:

 

C:

 

O:

 

Part II: Search Strategy

 

Using the Walden Library and other appropriate databases, locate five scholarly articles that pertain to a practice issue of interest to you and that is appropriate for an evidence-based practice project.

 

Step 1: Identify the resources you will utilize, or utilized, to find articles that pertain to your topic.


 

Electronic Databases

Research or Professional Organizations

Experts in the Field to Consult

Books, Encyclopedias, Handbooks

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Step 2: Identify search terms and criteria.

 

Keywords and Phrases

 

Major Authors

Inclusion Criteria

Exclusion Criteria

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Step 3: Identify Boolean search strings.

 

 

 


Part III: Analysis of Literature

 

Step 1: Summarize the five articles you select from your search efforts in the table below.

 

Summary Table of Analyzed Articles (you may determine your own headings)

 

Citation

Conceptual Framework/ Theory

Main Finding

Research Method

Strengths of Study

Weaknesses

Level of Evidence

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Step 2: Briefly summarize the history and purpose of your research question.

 

 

 

 

Step 3: Analyze the strengths and weaknesses of the existing literature.

 

Strengths

 

Weaknesses

 

 

 

 

 

 

Step 4: What gap exists in the current literature? Explain.

 

Elkins, M. Y. (2010). Using PICO and the brief report to answer clinical questions. Nursing, 40(4), 59–60.
Retrieved from the Walden Library databases.

 

Coursework Sample Content Preview:

Assignment: Application – PICO Analysis of Dementia, Delirium, and Depression
Name
Course
Instructor
Institution
Date
Background
In adults with depression, both pharmacological and non-pharmacological interventions have been used together or alone to treat different types of depression, including major depressive disorder: Psychotherapy is one form of non-pharmacological interventions for treating and there are different treatments including the Cognitive-Behavioral Therapy (CBT) (Gartlehner et al., 2017). Pharmacological interventions treat depression using medications. Cognitive-Behavioral Therapy (CBT) model is one of the interventions for treating adolescents and adults with depression. The therapeutic intervention targets decrease symptoms and intensity of depression, reducing relapse where they learn new ways to avoid getting depressed again and shortening the time a person is feeling depressed. Anxiety and depression are some of the most common psychological problems that affect many people and the main reasons for consultation. Identifying the best evidence on what is the best and most effective alternative to drugs in treating depression then is beneficial to improve health outcomes.
Possible keywords
Cognitive behavioral therapy (CBT), Cognitive behavioral therapy (CBT) and depression treatment, improvements in depression, depression drug therapy/ medication and pharmacotherapy and antidepressants
PICO Question and Literature Search
P: Adult patients with depression
I: Cognitive behavioral therapy (CBT)
C: Pharmacological interventions
O: Improve depressive symptoms, reduce depression levels and improve the cognitive function
PICOT Question: In adult patients with depression is Cognitive behavioral therapy (CBT) effective in improving depressive symptoms, reducing depression levels and improving the cognitive function when compared with pharmacological interventions
There is increased research on the effectiveness Cognitive Behavioral Therapy in treating anxiety and depression as CBT as mat have lasting effects compared to medication. Egede et al (2015) focused on telepsychology where psychotherapy delivered through telemedicine is an effective treatment for depression among older patients. There were no significant differences with care that is provided face to face in the same-room with the participants. The researchers used a randomized, controlled, open-label, non-inferiority trial, which improves reliability of the study findings as there was randomization and no selection bias .While the research highlighted that psychotherapy via telemedicine was beneficial, there is a need for more rigorous studies and systematic reviews to better understand whether relying on telemedicine affects the effectiveness of the intervention ad lasting effects after intervention.
There is research that compares the effectiveness of different pharmacological and non-pharmacological interventions to evaluate what is best suited for patients with depression. Gartlehner et al (2017) found out that there was high strength evidence of small beneficial treatment of second generation antidepressants, but there was a significant higher rate of adverse effects in case of discontinuati...
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