Create a 3-5-page submission in which you develop a PICO(T) question for a specific care issue and evaluate the evidence you locate, which could help to answer the question.

PICO(T) is an acronym that helps researchers and practitioners define aspects of a potential study or investigation. 

It stands for:

• P Patient/population/problem.
• I Intervention.
• C Comparison (of potential interventions, typically).
• O – Outcome(s).
• T – Time frame (if time frame is relevant).

The end goal of applying PICO(T) is to develop a question that can help guide the search for evidence (Boswell & Cannon, 2015). From this perspective, a PICO(T) question can be a valuable starting point for nurses who are starting to apply an evidence-based model or EBPs. By taking the time to precisely define the areas in which the nurse will be looking for evidence, searches become more efficient and effective. Essentially, by precisely defining the types of evidence within specific areas, the nurse will be more likely to discover relevant and useful evidence during their search.

You are encouraged to complete the Vila Health PCI(T) Process activity before you develop the plan proposal. This activity offers an opportunity to practice working through creating a PICO(T) question within the context of an issue at a Vila Health facility. These skills will be necessary to complete Assessment 3 successfully. This is for your own practice and self-assessment and demonstrates your engagement in the course.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

• Competency 1: Interpret findings from scholarly quantitative, qualitative, and outcomes research articles and studies.     
  • Explain the findings from articles or other sources of evidence.
• Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.     
  • Identify sources of evidence that could be potentially effective in answering a PICO(T) question.
  • Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.
• Competency 3: Apply an evidence-based practice model to address a practice issue.     
  • Define a practice issue to be explored via a PICO(T) approach.
• Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.     
  • Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.

Reference

Boswell, C., & Cannon, S. (2015). Introduction to nursing research. Burlington, MA: Jones & Bartlett Learning.

Professional Context

As a baccalaureate-prepared nurse, you will be responsible for locating and identifying credible and scholarly resources to incorporate the best available evidence for the purposes of enhancing clinical reasoning and judgement skills. When reliable and relevant evidence-based findings are utilized, patients, health care systems, and nursing practice outcomes are positively impacted.

PICO(T) is a framework that can help you structure your definition of the issue, potential approach that you are going to use, and your predictions related the issue. Word choice is important in the PICO(T) process because different word choices for similar concepts will lead you toward different existing evidence and research studies that would help inform the development of your initial question.

Scenario

For this assessment, please use an issue of interest from your current or past nursing practice.

If you do not have an issue of interest from your personal nursing practice, then review the optional Case Studies presented in the resources and select one of those as the basis for your assessment.

Instructions

For this assessment, select an issue of interest an apply the PICO(T) process to define the question and research it.

Your initial goal is to define the population, intervention, comparison, and outcome. In some cases, a time frame is relevant and you should include that as well, when writing a question you can research related to your issue of interest. After you define your question, research it, and organize your initial findings, select the two sources of evidence that seem the most relevant to your question and analyze them in more depth. Specifically, interpret each source’s specific findings and best practices related to your issues, as well explain how the evidence would help you plan and make decisions related to your question.

If you need some structure to organize your initial thoughts and research, the PICOT Question and Research Template document (accessible from the “” page in the Capella library’s Evidence Based Practice guide) might be helpful.

In your submission, make sure you address the following grading criteria:

• Define a practice issue to be explored via a PICO(T) approach.
• Identify sources of evidence that could be potentially effective in answering a PICO(T) question.
• Explain the findings from articles or other sources of evidence.
• Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.
• Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

• .

Additional Requirements

Your assessment should meet the following requirements:

• Length of submission: Create a 35-page submission focused on defining a research question and interpreting evidence relevant to answering it. A title page is not required but you must include a reference list.
• Number of references: Cite a minimum of four sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
• APA formatting: Format references and citations according to current APA style.

Assignment Guidelines:

• Take your article from a popular publication such as Time, Newsweek, US News and World Report, etc. You can look for a story from the APA at  to begin your search.
• The article must have been published within the past year.
• Do not use an Internet blog, a professional journal, or newspaper article. These sources are likely either too brief or too complex for this assignment.
• Look for a thorough article that is written for the general public.
• Ensure that your article relates to psychology and one of the subjects covered in the course (If you are not sure, refer to the table of contents of your text).
• Make sure that the article has sufficient depth and breadth (enough content and specific information) to allow a thorough critique.

Critiques of the article must include the following:

• Identify and articulate the key issue(s) in the article. Identify information/evidence in the article that supports its point of view and/or conclusions.
• Analyze both the students and the authors assumptions regarding the articles point of view and/or conclusions.
• Identify background information relevant to the articles point of view and conclusions.
• Explore and evaluate the issue(s) relevance to real world problems and solutions.
• Clarify the students own position, perspective and/or hypothesis.
• Explain the conclusions, implications and/or consequences of the article. Paper Requirements:
• The APA style format must be used in writing the paper.
• It should be between 5-7 pages in length (not including the title and reference page). Although outside sources are not required, any such material used in writing the paper must be properly cited according to the APA format with a complete bibliography of all source material.

 

Transcultural Perspectives in Mental Health Nursing

Review the attached PowerPoint presentation.  Once done and the following question ;

1.  Present your opinion, the status of mentally ill homeless patients.

          a.  Include the health risks and the societal perceptions of mentally ill people.

           b. What are health issues most likely to be seen in the homeless population?

2.  Discuss how to screen for substance abuse in a maternity ward.  Include the issues facing by single mothers of African American background as discussed in the Evidence-Based Practice box 10-5 on page 294

INSTRUCTIONS:

As stated in the syllabus, present your assignment in an APA format word document, Arial 12 font 

 A minimum of 2 evidence-based references besides the class textbook no older than five years must be used and quoted.  

A minimum of 800 words is required.  Please make sure to follow the instructions as given and use either spell-check or Grammarly before you post your assignment.  You must present the assignment according to how it is posted, answering the questions by number, essay-style assignments will not be accepted unless otherwise specified.  

Just answer questions

No minimum word count

APA format

 

Read Chapter 12

1. What are three questions you should ask yourself when you begin your job search?

2. What are the most common mistakes people make in preparing their rsums?

3. What should you know about your prospective employer before the job interview?

4. What should the interviewee try to achieve during a job interview? What should you look for? What red flags should you watch for?

5. What can you do in advance to prepare for the changes during the first year of employment?

6. Create your own SWOT analysis. How would you respond to your personal strengths and weaknesses if you were a prospective employer? How can you enhance your strengths and improve in areas of weakness?

7. Draw a career path for yourself, beginning with the present year and extending to the age of retirement. Be sure to include any twists and turns of the path you expect to experience along the way and any barriers you expect to encounter. How will you handle these experiences?

Do an online nationwide search for information about current job prospects in nursing.Compare opportunities in various regions of the country. Why do you think these opportunities are the same or different?

5. Develop a list of questions that you should ask a potential employer. What homework will you need to do to prepare for an interview? 

 

PICOT is utilized by the health care community to identify and study a nursing or medical practice problem. Consequently, PICOT examples that may provide insight into the use of the PICOT process, may not be relevant to nursing practice as they are based on a medical practice problem.

Describe the difference between a nursing practice problem and a medical practice problem. Provide one example of each. Discuss why is it important to ensure your PICOT is based on a nursing practice problem.

Stereotypes, as we have come to understand, are assumptions that some individuals have about certain groups. Stereotypes can span across race, gender, religion, ethnicity, sexual preference, and many other areas. In this discussion, we will explore one group that is often stereotyped and victimized by “othering.” 

Please watch the Disability video. This video explores the many ways we can celebrate and correct the misperceptions concerning disability. 

In your initial post, please address the following:

• Describe an experience you had that involved someone with a disability.  This can be yourself or someone else.  How did others respond to the person with the disability? 
• How could a video like this change that response?
• What do you think is the hardest part of responding to a person with a disability as a person rather than as a disability?
• What one step would you recommend to others to avoid othering those with disabilities?
• Did this video change your core understanding of disability?
• In your view, which created the biggest impact–the words that were spoken or the images the viewer saw?  Defend your choice. 
• How did this video change your core understanding of stereotypes?

 

To prepare:

• Select a client whom you have observed or counseled at your practicum site.
• Review pages 137142 of the Wheeler text and the Hernandez Family Genogram video in this weeks Learning Resources. Reflect on elements of writing a Comprehensive Client Assessment and creating a genogram for the client you selected.

The Assignment

Part 1: Comprehensive Client Family Assessment

With this client in mind, address the following in a Comprehensive ClientAssessment (without violating HIPAA regulations):

Demographic information

Presenting problem

History or present illness

Past psychiatric history

Medical history

Substance use history

Developmental history

Family psychiatric history

Psychosocial history

History of abuse/trauma

Review of systems

Physical assessment

Mental status exam

Differential diagnosis

Case formulation

Treatment plan

Part 2: Family Genogram

Prepare a genogram for the client you selected. The genogram should extend back by at least three generations (great grandparents, grandparents, and parents).

How does the community health nurse recognize bias, stereotypes, and implicit bias within the community? How should the nurse address these concepts to ensure health promotion activities are culturally competent? Propose strategies that you can employ to reduce cultural dissonance and bias to deliver culturally competent care. Include an evidence-based article that address the cultural issue. Cite and reference the article in APA format.

For this assignment you will continue to review current research from Souths 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 Purdues OWL:

A total of two 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 qualitative methodology (review our reading assignments). Web pages, magazines, textbooks, and other books are not acceptable.

Each annotation must address the following critical elements:

• Explanation of the main purpose and scope of the cited work
• Brief description of the research conducted
• Value and significance of the work (e.g., studys findings, scope of the research project) as a contribution to the subject under consideration
• Possible shortcomings or bias in the work
• Conclusions or observations reached by the author
• Summary as to why this research lends evidence to support the potential problem identified specific to your role specialization.

Submissions Area:

• Please submit to the Submissions Area by the due date assigned.

  

Assignment:

Respond to at least two of your colleagues by providing an additional scholarly resource that supports or challenges their position along with a brief explanation of the resource.

Each response must have at least 2 references no more than five years old

Colleagues Response # 1

Psychotherapy and biological basis

         I believe that psychotherapy has a biological basis and there continues to be emerging evidence supporting this. Psychotherapy has ability to touch many aspects of the clients lives to include self-esteem. Family, work, and relationships (Laureate Education, 2016). Psychotherapy can work alone or in conjunction with psychopharmacology and it is often the first line of treatment (Laureate Eductaion, 2016).

         There have been studies on brain changes after psychotherapy for depression, anxiety disorders, and borderline personality disorder that have been published (Karlsson, 2011). Studies have focused on comparing behavior therapy against psychopharmacologic agents such as antidepressants and the changes in the brain with both modalities. In the recent study by Karlsson and colleagues, clear differences emerged between short-term psychodynamic psychotherapy and fluoxetine among patients with MDD (Karlsson, 2011).

           Many psychotherapies attempt to enhance patients’ problem-solving capacities, self-representation, and regulation of affective states. The brain areas that play a role in these functions include the dorsolateral prefrontal cortex, ventral anterior cingulate cortex, dorsal anterior cingulate cortex, ventral and dorsal subregions of the medial prefrontal cortex, posterior cingulate cortex, precuneus, insular cortex, amygdala, and ventrolateral prefrontal cortex. For example, the mechanism behind the effectiveness of cognitive therapy for patients with MDD could be through an increase in prefrontal function, which is involved in cognitive control, while antidepressant medications operate more directly on the amygdala, which is involved in the generation of negative emotion (Karlsson, 2011).

Culture, religion, and socioeconomic influences on the perception of psychotherapy treatment

It is important for the advanced nurse practitioner to always treat each client in a holistic manner because each client differ, based on their cultural, religion beliefs, and socioeconomic background. Culture and beliefs affect many aspects of psychosocial intervention, and cultural assessment will be imperative during the initial treatment phase. This assessment will facilitate the groundwork for treatment outcomes and interventions, indicated to tailor the treatment plan to the individual treating. Cultural evaluations completed by the healthcare professional will promote the trust that is imperative in a professional therapeutic relationship (Wheeler, 2014).

Some patients may have strong spiritual beliefs which provides stabilization in the treatment hierarchy framework for practice (Wheeler, 2014). And individuals spiritual beliefs are often a significant strength and/or protective factor that the health professional can utilize to assist with recovery or coping and in addition, incorporating the spiritual aspect of life into therapy ensures that existential needs are not swept under the carpet with psychological/psychiatric terms (such as depression) (Brown, Elkonin,  & Naicker, 2013).

Socioeconomic factors may determine if the client would have access to care, if the client would be adherent to the treatment and if the outcome would be successful or not. According to Hawley, Leibert, & Lane, (2014), socioeconomic Status affects therapeutic outcomes and significance of therapeutic intervention because clients educational level and benefits of health insurance have shown greater compliance with the treatment regimen, therefore, improving client outcome and follow-up.

For Nurse Practitioners to successfully diagnose and treat mental illness ethnicity, religion, race, social, economic Status, and culture are imperative to address, and with the competence gained during the initial goal setting and assessment all the factors above must be thoroughly assessed and discussed (Wheeler, 2014). Preparing for successful intervention will encompass the whole patient to include support, socioeconomic means to healthy living and personal spiritual beliefs will identify what drives the client internally for holistic health.

Colleagues Response # 2

Explanation of Whether Psychotherapy Has a Biological Basis

           Psychotherapy is an interaction between a trained professional and a patient to explore thoughts, feelings, and behaviors with the goal of problem-solving or achieving higher levels of functioning (American Psychiatric Association, 2016). Psychotherapy can be helpful with problems like issues in coping with daily life; traumatic life event, medical illness or loss of a loved one; and specific mental disorders, like depression or anxiety (American Psychiatric Association, 2016).  For example, to show that psychotherapy has a biological basis on the brain and the body, In a study with a client suffering from PTSD who participate in psychotherapy show marked improved dysfunctional cognitive and blood pressure  compare with those with no therapy (Schubert et al., 2019). Just like learning to perceive and incorporate new informations, views, and internal processing, psychotherapy produces lasting, detectable physical changes in the brain (Kandel, 2014).

Cultural influences on Psychotherapy Treatments

For an APPN to treat and diagnose mental illness effectively, the APPN must consider the patient culture, religion and socioeconomics influences to recommend the appropriate psychotherapy treatments (Wheeler, 2014). Although it is not possible to have a vast knowledge base regarding all cultures, practitioners should have a working knowledge of the clients background and research their culture (Wheeler, 2014). Using generalized knowledge of culture will not be appropriate to work with diverse population.  If the practitioner has conflicting information of the clients culture, asking question will help build a rapport with the client. For example, a Spanish woman hearing voices of her death husband does not mean she is psychotic. As a practitioner, with the knowledge of different culture, he will not prescribed treatment since what the patient is experiencing is cultural related (Wheeler, 2014).

Religious influences on Psychotherapy Treatment

           It is important to consider religion in psychotherapy sessions.  Some therapeutic tools such as meditation, prayer, spiritual journaling, forgiveness protocols, using biblical texts to reinforce healthy mental and emotional habits can lead clients to let go of unhealthy anger and move past an abusive situation without justifying the abuse (Kersting, 2015). Clients with religious or spiritual background will be sensitive and willing to interact religiously. Thereby helping them to trust the therapist and hence brings some positive aspect of the human experience in the therapy room. Some people describe the beauty of spiritually guided therapy as experiencing a third presence in the room a spiritual presence or a God presence. There’s a mystery being revealed to the patient in that presence; it is a sort of an epiphany that can be extremely useful in therapy (Kersting, 2015). As being religious can shape culture, being empathetic to patients beliefs and incorporating them into therapeutic plan enhances professional dialogue in a therapeutic meaning (Dilip, Barton & Elyn, 2017).When  the client have a relationship of confidence and empathy with their psychotherapist, there is an efficacy of the treatment

Socioeconomics Influences on psychotherapy Treatment

Socioeconomic factors can hinder clients from getting psychotherapy. Most client who dont have insurance are unable to pay for services, they are more likely to be discouraged from seeking treatment.  Hawley, Leibert, and  Lane, (2014), noted that social, economic status has a significant influence on therapy. In a research study, results show that  with higher education and access to health insurance even at a free counseling clinic may improve counseling outcome and retention.  The study also pointed out individuals with lower social, economic status levels as having greater dysfunction and greater goal disagreement about treatment has less successful counseling outcomes. These patients are less motivated and lack social support (Hawley, Leibert & Lane, 2014). There are community based services that are also offer for free or low cost based on income. It is also important to know that those with low income have life problems and mental illness as well as client with higher income. ( Jeste, Palmer, Rettew & Boardman, 2015).

Conclusively, for an PMHNP to diagnose and treat mental illness effectively,  they must considered the ethnicity, religion, race, social, economic status, and culture of the client Even though, it is not possible to culturally be competent in all cultures, a working knowledge of the backgrounds of those who most seek treatment is essential (Wheeler, 2014).