Evidence Synthesis Paper Essay

Evidence Synthesis Paper Essay

Evidence synthesis is the systematic process of identifying, selecting, and bringing together information from different sources to inform a particular topic or help make a decision on a specific issue. It is usually conducted unbiasedly to produce evidence that can be used to inform policy formulation and changes, practice, and identify research gaps. The focus of this paper is to provide evidence synthesis on the diabetes practice problem based on two recent quantitative and one qualitative research source. The level of evidence for the sources will also be identified.

Introduction of the National Practice Problem

The selected practice problem is diabetes. Diabetes has long been identified as a practice problem due to its high pressure on the healthcare system and different health populations. Diabetes is a group of chronic metabolic diseases characterized by high blood glucose levels due to blood glucose regulation problems or low or no insulin production in the body. There are three types of diabetes: type1 diabetes or Juvenile diabetes, type 2 diabetes, and gestational diabetes. Type 2 diabetes is the most common type, which occurs when the body is resistant to insulin or does not produce enough insulin. In type 1 diabetes, the body produces little to no insulin. Gestational diabetes is a rare type of diabetes that occurs during pregnancy and disappears after birth; however, people who get gestational diabetes are at a higher risk of type 2 diabetes later in life.

The number of new cases, diabetes prevalence, and complications have increased steadily over the past few decades. According to the World Health Organization (n.d.), about 422 million people globally have diabetes, mostly from low- and middle-income countries. About 1.5 million deaths are attributed to diabetes annually. In the US alone, more than 30 million people have diabetes, and many people do not know they have it. Additionally, it is the seventh leading cause of death and the most expensive condition to treat and manage (Healthy People 2030, n.d.).

Sources of Research Evidence

The qualitative article is “Challenges to Diabetes Self-Management for Adults with Type2 diabetes in Low-Resource Settings in Mexico City: A Qualitative Descriptive Study” by Whittemore et al. (2019). The research in this article studied the perceptions of type 2 diabetes patients and care providers to identify the challenges patients from low-resource settings encounter in diabetes self-management. The challenges faced by type 2 diabetes patients in diabetes self-management, as found by this study, include inadequate social support and resources, difficulties in lifestyle modification, and mental health issues.

The first quantitative article is “Factors influencing Healthcare Providers’ attitude and willingness to use information technology in diabetes management” by Seboka, Yilma & Birhanu (2021). With the increased use of healthcare technology, the study seeks to understand the willingness and attitude of care providers to use information technology in managing diabetes patients. The findings are that care providers are willing and have a positive attitude toward using information technology to help diabetes patients.

The second quantitative article is Diabetes and the risk of hospitalization for infection: the Atherosclerosis Risk in Communities (ARIC) study by Fang et al. (2021). The study’s primary objective was to identify and assess the relationship between diabetes and the risk of infection-associated hospitalization and mortality. The study found that diabetes confers a higher risk for infection-related hospitalization.

Analysis of the Practice Problem

Diabetes is one of the significant practice problems globally, nationally, and locally. The most common type of diabetes is type 2 diabetes. Diabetes causes complications such as retinopathy and diabetic foot problems-leading to amputations, vision loss, and kidney problems. These complications mainly cause the rise in the cost of diabetes management and treatment. However, even the management of diabetes without complications is expensive. The high cost is felt by the patient and the healthcare system following the need to adjust the patient’s lifestyle, cost of healthcare technology, and meet the care needs of the diabetes patients. Diabetes affects different populations disproportionately, and there are disparities in diabetes care access. Patients, especially those from low-resource settings, face myriad challenges in diabetes self-management. Diabetes is also a major cause of hospitalization and mortality.

Significance and Prevalence of the Practice Problem

Diabetes considerably affects the quality of life of patients. It not only increases the risk of other comorbidities and complications but also the risk of early death. More so, diabetes complications lead to life-threatening disabilities and conditions. Diabetes is also known to cause stroke, cardiovascular diseases, blindness, kidney failure, and lower limb amputation. Additionally, research shows a relationship between diabetes, hearing loss, and various forms of cancer (Abudawood, 2019). Furthermore, diabetes can cause stigma in the communities. Diabetes-related stigma negatively affects social relationships in the community, may lead to a poor attitude toward self-management, and therefore increase the risk of complications.

Diabetes also affects the patients’ mental health through diabetes-related distress, anxiety, and depression. As mentioned earlier, about 422 million people have diabetes. About 10.5% of the US population has diabetes, yet people living with diabetes do not know they have it. About 95% of the total diabetes cases are type 2 diabetes cases, mainly caused by excess weight and physical inactivity (WHO, n.d.). About 9 million people worldwide have type 1 diabetes, with a majority of them living in high-income countries.

Evidence Synthesis

The three selected articles can be used to address the diabetes practice problem adequately. The main themes of the first, second, and third articles are diabetes self-management and low-resource settings, diabetes management and healthcare technology, and diabetes and hospitalization risk, respectively. The three themes are essential aspects surrounding diabetes practice problems. Given that there are disparities in diabetes, especially with type 2 diabetes, studying diabetes self-management in low-income settings helped understand how to address the practice problem since it is more prevalent in these settings. Healthcare technology, on the other hand, can facilitate diabetes patient management, thus improving health outcomes for diabetes patients. Diabetes and its complications are significant causes of hospitalization; thus, the third article can contribute to addressing the problem.

The salient evidence emerging from these sources includes that addressing the challenges faced by diabetes patients in diabetes self-management can considerably improve the health outcomes and quality of life of diabetic patients. Additionally, healthcare providers should be trained regularly on the use of emerging diabetes healthcare technology to facilitate diabetes management easily. Proper diabetes management reduces the risk of diabetes complications, thus reducing the risk of hospitalization following diabetes-related infections.

The sources have various things in common and also have differences. The three sources have one major theme in common, which is diabetes management. All the sources have a similar aim: understanding diabetes management, thus reducing complications, hospitalizations, and mortality rates. However, the first source focuses on the challenges patients face in diabetes self-management; the second is the use of healthcare technology in diabetes management; the third focuses on diabetes and the risk of hospitalization. Additionally, both the first and third sources’ findings emphasize the burden of diabetes on patients from low-income settings. On the contrary, the second source does not mention any populations since its main focus is the care providers.

The overall objective for the practice problem, as seen in the evidence presented in the sources, is that proper diabetes management, especially self-management facilitated by healthcare technology, can help address diabetes by reducing diabetes complications and hospitalizations, thus improving health outcomes and quality of life for diabetes patients.

Appraisal of the Evidence to Address the Practice Problem

The qualitative study presents the level of evidence 5, while the two quantitative studies present the level of evidence 3. Single-source qualitative or descriptive studies fall under the level of evidence 5, while quantitative experimental studies fall under the level of evidence 3. The evidence from these studies is reliable and valid. The methodologies used in the research are known to provide valid results. More so, understanding the practice problem acquired from the articles can be used to improve diabetes management and thus help address it.

The quality rating of the evidence is level A, since the recommendations are based on sound, reliable and consistent scientific evidence. The evidence obtained from the above-discussed sources adequately addresses the practice problem. However, I believe that adequately addressing a practice problem such as diabetes requires a consideration of the prevention of the disease rather than management and treatment only. The sources of evidence discussed above did not mention how new cases of diabetes can be prevented, which is an essential factor in addressing the problem.

Conclusion

Diabetes is a significant health concern and a national practice problem. It is the costliest health condition to treat and manage. Research is used to inform evidence-based practice in diabetes treatment and management. The synthesis of evidence from three research articles, two quantitative and one qualitative article presented above, can contribute to addressing the practice problem. The central theme of the evidence presented above is diabetes patient management. The quality of evidence is high since the evidence is justifiable, applicable, and reliable in addressing the practice problem.

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References

Abudawood, M. (2019). Diabetes and cancer: a comprehensive review. Journal of Research in Medical Sciences: The Official Journal of Isfahan University of Medical Sciences, 24. https://doi.org/10.4103%2Fjrms.JRMS_242_19

Fang, M., Ishigami, J., Echouffo-Tcheugui, J. B., Lutsey, P. L., Pankow, J. S., & Selvin, E. (2021). Diabetes and the risk of hospitalization for infection: the Atherosclerosis Risk in Communities (ARIC) study. Diabetologia, 64(11), 2458-2465. https://doi.org/10.1037/hea0000710

Healthy People 2030. (n.d.).Diabetes, Overview, and Objectives. Retrieved from https://health.gov/healthypeople/objectives-and-data/browse-objectives/diabetes

Seboka, B. T., Yilma, T. M., & Birhanu, A. Y. (2021). Factors influencing healthcare providers’ attitude and willingness to use information technology in diabetes management. BMC Medical Informatics And Decision Making, 21(1), 1-10. https://doi.org/10.1186/s12911-021-01398-w

The World Health Organization. (n.d.). Diabetes. https://www.who.int/health-topics/diabetes#tab=tab_1

Whittemore, R., Vilar-Compte, M., De La Cerda, S., Marron, D., Conover, R., Delvy, R., Lozano, A. M. & Pérez-Escamilla, R. (2019). Challenges to diabetes self-management for adults with type 2 diabetes in low-resource settings in Mexico City: a qualitative descriptive study. International Journal For Equity In Health, 18(1), 1-10. https://doi.org/10.1186/s12939-019-1035-x

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Purpose
The purpose of this assignment is to present a synthesis of evidence using the three articles you selected in Weeks 3, 4, and 5. The development of the Johns Hopkins Individual Evidence Summary Tool builds a body of evidence about a practice problem. Adding research studies to the Johns Hopkins Summary Tool builds the foundation for the synthesis of evidence for a practice change.

Please note that this is the first part of a 2-part paper. You will receive feedback from your course faculty on this assignment. You will be required to use the feedback to revise this paper. In Week 7, you will add to this paper and submit as the Week 7 Assignment.

Instructions
Follow these guidelines when completing the assignment. Contact your course faculty if you have any questions.

Review the directions and complete the Johns Hopkins Individual Evidence Summary Tool. Use the 3 articles: 2 quantitative and 1 qualitative selected in Weeks 3, 4, and 5. These must be recent research articles less than 5 years old and be related to a National Practice Problem.
Link (Word doc): Johns Hopkins Individual Evidence Summary ToolLinks to an external site..
Use the most current version of Microsoft Word that is the format for all Chamberlain University College of Nursing. You can tell the document is saved as the current version because it will end in \”docx.\”
All Chamberlain University policies related to plagiarism must be observed. This written assignment will be screened for originality by Turnitin.
Review the rubric for the grading criteria.
The assignment includes the following components:

Title Page
Introduction
Introduce the practice problem.
Discuss sources of research evidence identified in Weeks 3, 4, and 5.
Analysis of the Practice Problem (1-2 paragraphs)
Present the significance of the practice problem.
Present the prevalence of the practice problem from the selected articles.
Evidence Synthesis: Using the three articles (2 quantitative and 1 qualitative), write a synthesis of evidence to address the selected practice problem. In the synthesis of evidence include the following:
Identify the main themes, and salient evidence that emerge from the sources. (Cited)
Compare and contrast the main points from all sources. (Cited)
Present an objective overarching synthesis of research evidence about the practice problem. (Cited)
Appraisal of the Evidence to Address the Practice Problem: Include the following:
Identify the level of evidence.
Provide a quality rating of the evidence.
Appraise and support the suitability of the evidence to address the practice problem.
Conclusion
In one concise paragraph, provide a clear and logical conclusion summarizing the paper.
Summary Table: Complete all sections of the Summary Table of Evidence using the Johns Hopkins Individual Evidence Summary Tool. Include the following:
Two Quantitative Research Studies (selected in Weeks 3 & 4 Discussion)
One Qualitative Research Studies (selected in Week 5 Discussion)
Complete all sections completely and identify the quality and the levels of evidence.
Appendix A
Attach the completed Johns Hopkins Summary Tool as Appendix A.
Length: 5-7 pages (not including title page, reference page, or appendix)
1-inch margins
Double-spaced pages
12-point Times New Roman or 11-point Arial font
Headings & subheadings
In-text citations
Title page
Reference page
Standard English usage and mechanics
Course Outcomes
This assignment enables the student to meet the following course outcomes:

Critically appraise literature for level and quality of evidence to support practice change. (POs 1, 3, 5, 6, 7)
Appraise global healthcare practice problems and DNP practice relevant to advanced nursing practice. (POs 1, 3, 9)
Due Date
By 11:59 p.m. MT on Sunday
Late Assignment Policy applies
Rubric
W5 Assignment Grading Rubric
W5 Assignment Grading Rubric
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeIntroduction
Requirements:
1. Introduce the practice problem.
2. Discuss sources of research evidence selected in Weeks 3, 4, and 5.
20 pts
Includes all requirements and provides an in-depth introduction.
18 pts
Includes all requirements with a sufficient introduction.
16 pts
Includes fewer than all requirements and/or provides a partial introduction.
0 pts
Includes fewer than all requirements and/or provides an undeveloped introduction.
20 pts
This criterion is linked to a Learning OutcomeAnalysis of the Practice Problem
Requirements:
1. Present the significance of the practice problem.
2. Present the prevalence of the practice problem.
30 pts
Includes all requirements and an provides an in-depth analysis of the practice problem and prevalence.
27 pts
Includes all requirements and a sufficient analysis of the practice problem and prevalence.
24 pts
Includes fewer than all requirements and/or provides a partial analysis of the practice problem and prevalence.
0 pts
Includes fewer than all requirements and/or provides an undeveloped analysis of the practice problem or prevalence.
30 pts
This criterion is linked to a Learning OutcomeEvidence Synthesis
Requirements:
1. Present main themes, and salient findings that emerge from the sources. (Cited)
2. Compare and contrast the main points from all sources. (Cited)
3. Present an objective overarching
synthesis of research evidence about the practice problem. (Cited)
40 pts
Includes all requirements and provides an in-depth evidence synthesis.
36 pts
Includes all requirements and provides a sufficient evidence synthesis.
32 pts
Includes fewer than all requirements and/or provides a partial evidence synthesis.
0 pts
Includes fewer than all requirements and/or provides an undeveloped evidence synthesis.
40 pts

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This criterion is linked to a Learning OutcomeAppraise the Evidence
Requirements:
1. Level of evidence.
2. Quality rating of evidence.
3. Appraise and support the suitability of the evidence to address the practice problem.
20 pts
Includes all requirements and provides an in-depth appraisal of the evidence.
18 pts
Includes all requirements and provides a sufficient appraisal of the evidence.
16 pts
Includes fewer than all requirements and/or provides a partial appraisal of the evidence.
0 pts
Includes fewer than all requirements and/or provides an undeveloped appraisal of the evidence.
20 pts
This criterion is linked to a Learning OutcomeConclusion
Requirements:
In one concise paragraph, provide a clear and logical conclusion that summarizes the paper.
10 pts
Includes all requirements and provides an in-depth conclusion.
9 pts
Includes all requirements and provides a sufficient conclusion.
8 pts
Includes fewer than all requirements and/or provides an in-depth conclusion.
0 pts
Includes fewer than all requirements and/or provides an undeveloped conclusion.
10 pts
This criterion is linked to a Learning OutcomeSummary Table
Requirements:
1. Two quantitative research studies.
2. One qualitative research study.
3. Complete all sections completely and identify the quality and the levels of evidence.
15 pts
Includes all requirements and provides an in-depth summary table.
13 pts
Includes all requirements and provides a sufficient summary table.
12 pts
Includes fewer than all requirements and/or provides a partial summary table.
0 pts
Includes no requirements and/or provides an undeveloped summary table.
15 pts
This criterion is linked to a Learning OutcomeAppendix A
Requirements:
Attach the completed Johns Hopkins Summary Tool as Appendix A.
10 pts
Includes tool in the appendix.
0 pts
Does not include the tool in the appendix.
10 pts
This criterion is linked to a Learning OutcomeAPA Style and Standards
Requirements:
1. Use appropriate Level I headers.
2. Reference and citations are in current APA style.
3. Paper length is 5-7 pages excluding title, reference pages, and appendix.
10 pts
Includes all requirements and presents excellent APA style and standards.
9 pts
Includes 3 requirements and sufficient APA style and standards.
8 pts
Includes fewer than all requirements and/or provides partial APA style and standards.
0 pts
Includes fewer than all requirements and/or provides an undeveloped APA style and standards.
10 pts
This criterion is linked to a Learning OutcomeClarity of Writing
Requirements:
1. Standard English grammar and sentence structure.
2. No spelling or typographical errors.
3. Organized presentation of ideas.
20 pts
Includes all requirements and demonstrates excellent clarity of writing.
18 pts
Includes all requirements and demonstrates sufficient clarity of writing.
16 pts
Includes fewer than all requirements and/or demonstrates basic clarity of writing.
0 pts
Includes 1 or fewer requirements fewer than all requirements and/or demonstrates undeveloped clarity of writing.
20 pts
Total Points: 175