NRS433V GCU Relationship Between Obesity & Diabetes PICOT Statement Paper

Running head: NURSING RESEARCH PROJECT – QUALITATIVE RESEARCH Nursing Research Project: Qualitative

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Research Name Course Date 1 NURSING RESEARCH PROJECT – QUALITATIVE RESEARCH 2 Nursing Research Project: Qualitative Research The research project focuses on the evaluation of the evidence existing regarding the relationship between obesity and diabetes mellitus type II. This research project mainly focuses on the adult population, which is the most affected by this chronic disease. The present report critically analyzes the qualitative information provided by the Look AHEAD research group (2003) regarding this topic. The group specializes in the evaluation of the different causes of diabetes and the design of an appropriate prevention strategy. Background information Even while the cause-effect relationship between obesity and diabetes mellitus type II has been studied in detail, there have been only a few studies that systematically evaluated the causes and impact that obesity poses on diabetes, and on the common complications of the disease on the long run. This lack of information has failed the multiple strategies implemented to try to prevent the disease, such that the number of diabetic people in the United States continues to increase year after year, to the point that physicians currently refer to it as an epidemy. In this regard, the strategies developed so far had focused on the weight loss of the individual. However, as they did not address the entirety of the problem, the impact on the incidence rate of diabetes was negligible in most of the cases. The evaluation carried out by the Look AHEAD research group (2003) is thus crucial for the development of efficient, long-term strategies to reduce the risk of contracting the disease. The research questions addressed through the study is: • Why do weight loss procedure fail to reduce the risk of diabetes? • What other factors may affect the relationship between obesity and diabetes? • How should these factors be part of the long-term effective preventive strategy? NURSING RESEARCH PROJECT – QUALITATIVE RESEARCH 3 Method of the study While the Look AHEAD research group (2003) uses some elements of quantitative research such as the comparison with a control group, the survey carried out is mainly qualitative in the sense that it focuses on the evaluation of the qualitative differences between both the intervention group and the control group. In this regard, the study evaluates the risk of developing the disease in the two groups by comparing how long each of the individuals of the groups takes to produce the first symptoms of the disease, and whether or not the implemented strategies are effective at prolonging this time. Moreover, the study focuses on the evaluation of several variables, such as the presence of cardiovascular diseases, or the symptoms of common complications of the disease like nephropathy, circulatory problems that lead to the necrosis and amputation of the limbs or glaucoma. The overall objective of including these variables in the study is to assess not only the risk of developing the disease but most importantly how obesity affects diabetes and how it may accelerate the process leading to earlier complications. Additionally, the independent variable, that is the intervention carried out on the test group is as well of qualitative nature, as it evaluates the combined application of intensive lifestyle changes including both dieting and exercising. This research approach founds over the exhaustive evaluation of the published literature regarding the relationship between obesity and diabetes. In this regard, the Look AHEAD research group (2003) has evaluated several of the most relevant studies published in the prior five years. In such literature review, the researchers considered both qualitative and quantitative methods to gain a broader point of view and evaluate the possible variables to include in the study carried out. Moreover, this extensive literature review enabled the researchers to build a NURSING RESEARCH PROJECT – QUALITATIVE RESEARCH 4 robust conceptual framework in which to found the current research, hence resulting in a logic flow of the analyses carried out and the conclusions derived from such analyses. The implemented strategy includes: • Training sessions oriented to provide necessary information about diabetes and the impact of obesity on diabetes • Weight loss and regular weight monitoring • Exercising Main results of the study According to the obtained results, the obesity of the individuals would not only increase the incidence rate of diabetes but also of suffering from cardiovascular diseases. As a result, they observed how the higher body mass index of the individuals seemed to relate to a higher incidence rate of both diabetes and cardiovascular diseases. Moreover, the results obtained highlight how obese diabetic patients are more likely to experience cardiovascular complications at a substantially earlier stage than non-obese diabetics. The obtained result is thus highly alarming and warns about the necessity of developing effective weight loss strategies to decrease the burden of severe complications on diabetic patients. Nonetheless, the authors suggest the importance of monitoring the incidence that obesity has on the developing of cardiovascular complications in people with diabetes in future follow-up studies on the long-term, as well as the evaluation of the long-term effects of the implemented lifestyle change strategy. For this purpose, the researchers suggest the measurement of several variables on an annual or biannual basis. Among these variables, the follow up would focus on specific NURSING RESEARCH PROJECT – QUALITATIVE RESEARCH diagnostic criteria of diabetes and uncontrolled diabetes such as the level of fasting blood glucose, the correct functioning of the kidneys through the measurement of creatinine and the monitoring of cholesterol and triglycerides. It should as well consider indicators of cardiovascular disease through the realization of a cardiovascular fitness test and an electrocardiogram. Ethical considerations The researchers seem to have requested the approval of an Ethical Review Board and have required the informed consent of the 5,000 people included in the study. Moreover, they provide all the necessary means to protect both their private information and whether they are part of the treatment or the control group. They also seem to have taken into account other potential ethical aspects of concern, such as the voluntary participation in the study. They do not look to evaluate the ethical considerations resulting from the inclusion of the different participants in either the treatment or the control group. However, the fact that the selection of the two different groups was random and used a website model independent from the researcher provides all the participants with the same probability to be part of any of the two groups. Conclusions The provided results and the proposed follow up are congruent with the planed thesis statement and enable the researchers to evaluate whether or not obesity has any incidence on the onset of both diabetes and its most common complications, such as cardiovascular problems or nephropathy. Moreover, the extensive literature review carried out highlights the importance of the study, as it tries to tackle a critical aspect relating obesity to the risk of developing diabetes and how it will affect the prognosis of the disease. This information is crucial for the 5 NURSING RESEARCH PROJECT – QUALITATIVE RESEARCH development of an effective preventive strategy oriented at decreasing the high incidence rate of diabetes mellitus type II among the American citizens. From this point of view, the information provided in the selected paper does not only provide useful takeaways to nursing practice but most importantly outlines the methods to use when evaluating the cause-effect relationship with multiple other diseases. In this regard, the systematic approach to the problem as that carried out by the researchers of the Look AHEAD group applies to any other nursing research project. 6 NURSING RESEARCH PROJECT – QUALITATIVE RESEARCH 7 Reference Look AHEAD Research Group. (2003). Look AHEAD (Action for Health in Diabetes): design and methods for a clinical trial of weight loss for the prevention of cardiovascular disease in type 2 diabetes. Controlled clinical trials, 24(5), 610-628. Running Head: QUANTITATIVE RESEARCH CRITIQUE AND ETHICAL ISSUES Quantitative Research Critique and Ethical Considerations Wendy Fernandez Grand Canyon University NRS – 433V Cindy Mcdonald 09/24/2018 1 QUANTITATIVE RESEARCH CRITIQUE AND ETHICAL CONSIDERATIONS 2 Quantitative Research Critique and Ethical Considerations Background The previously presented case seeks to respond to the research questions meant to identify the possible pieces of evidence that may show that weight loss significantly contributes towards the reduction of Diabetes Mellitus type II amongst adults in the US. This research question needs the researcher to look for the previously presented pieces of evidence from both a qualitative as well as a quantitative approach which would, in the long run, contribute a large part towards coming up with a conclusive answer that satisfies the case. This paper primarily focuses on using the quantitative approach, individually, analyzing one of the previously highlighted pieces of research which would form a basis for making sound and final recommendations. The first part of this paper looks at the background of the presented study, the findings and their significance to nursing practice, the methodology adopted and finally, the possible issues of concern from an ethics perspective offered by the authors and the entire piece of work. A study presented by Laaksonen et al., (2005) as highlighted in the previous paper sought to determine the possible impacts that increased physical activity amongst the affected adults would help to prevent the occurrence or risks of Diabetes Mellitus Type II. This study focused primarily on the determination of the effects that weight loss amongst the affected population may reduce the impacts of diabetes mellitus type II. Therefore, this paper based its arguments from the notion that a change in the overall lifestyle of the population may contribute a large part towards the perceived reduction in risks of diabetes mellitus type II. However, the authors in this case claim that although the clinical trials performed by the various parties create a connection between a reduction in risks of diabetes mellitus type II due to a change in the overall lifestyle. QUANTITATIVE RESEARCH CRITIQUE AND ETHICAL CONSIDERATIONS 3 The previously presented studies do not, however, show the link or effects of leisure time physical activity otherwise referred to as LTPA to reducing effects of the condition. Method In the attempt to come up with conclusive findings, the authors, in this case, performed a post hoc evaluation seeking to identify the possible role or significance of LTPA in the reduction of risks associated with diabetes mellitus type II amongst the various adults in the selected regions. The study chose a total of 487 subjects comprised of both men and women who suffered from glucose tolerance and previously undertook the LTPA questionnaires in the past 12 months. Besides, this research identified the subjects from the Finish Diabetes Prevention Study which serves as a trial based on randomized analysis primarily addressing the issues of weight loss, diet changes and also leisure time physical activities amongst the targeted population. Results After conducting the study, the researchers, in this case, gathered all the required information from the previous issues questionnaires for further analysis. The authors after analyzing the collected data tabled the results and found out that some of the participants adopted measures meant to improve their lifestyles. For instance, approximately 63-65% of the participants changed their lifestyle by taking vigorous leisure-time physical activity. Such a change in the lifestyle contributed a large part in reducing the chances of them suffering further from diabetes mellitus type II. The study after considering the differences in behavior of the subjects over the 4.1 years period of follow up concluded that some of the participants recorded an improvement in their overall physical health. The research found that the presented study showed a difference in health improvement between the [participants who adopted positive QUANTITATIVE RESEARCH CRITIQUE AND ETHICAL CONSIDERATIONS 4 measures in regards to the proposed lifestyle changes to those who ignored them. The research found out that a total of 95% of the participants practiced at minimum moderate, vigorous and also strenuous LTPA which resulted into a reduced level of risks of getting diabetes Mellitus type II a ta value of 0.5. The presented findings may bring about a set of implications from a clinical and also a medical perspective. For instance, the study completed shows that those people who practiced LTPA vigorously or at a minimum moderately stood a better chance of reducing the risks of diabetes mellitus type II. Further, the study showed that an increase in physical activity amongst the affected population formed the basis for reducing the risks or effects of diabetes mellitus type II. This conclusion means that the affected community, especially, those who suffer from diabetes mellitus type II and are overweight or obese may benefit from this study. The primary significance of this study based on the obtained results revolves around creating a connection between changes in lifestyle and reducing the impacts or risks of diabetes mellitus type II amongst the overweight or obese populations. With such evidence-based research, the findings may play a critical part in boosting the overall approach that the medical and clinical teams use to address the issues of diabetes mellitus type II from a weight and lifestyle perspective. The study implies that the clinical teams in addition to using the various medical procedures should consider advocating and supporting the use of leisure time physical activity with the primary aim of boosting a healthy lifestyle of the affected population to reduce the risks of diabetes mellitus type II. The obese or overweight communities who suffer from diabetes mellitus type II may need to practice strenuous or vigorous LTPA with the aim of improving their lifestyle and also to support the offered QUANTITATIVE RESEARCH CRITIQUE AND ETHICAL CONSIDERATIONS 5 medications which in the long run would create a better platform for reducing the risks or impacts of diabetes mellitus type II. Ethical considerations Based on the provided information, this study does not show the criteria for selecting the women and men who participated in the research. Further, the study does not give details on seeking consent from the participants before enrolling them in the study. Besides, the researchers, in this case, used a relatively long period to complete the research without considering the various factors that would undermine the credibility of the final results. Finally, the analysis, in this case, fails to exclusively provide information on the practices used to guarantee the validity of the questionnaires used. QUANTITATIVE RESEARCH CRITIQUE AND ETHICAL CONSIDERATIONS 6 References Laaksonen, D. E., Lindström, J., Lakka, T. A., Eriksson, J. G., Niskanen, L., Wikström, K., … & Ilanne-Parikka, P. (2005). Physical activity in the prevention of type 2 diabetes: the Finnish diabetes prevention study. Diabetes, 54(1), 158-165. Running head: PICOT RESEARCH QUESTIONS PICOT Research Questions Name: Wendy Fernandez Course: NRS – 433V Date: 9/16/18 1 PICOT RESEARCH QUESTIONS 2 PICOT Research Questions The proposed research question addresses the efficiency of the different techniques used in the prevention of diabetes. Specifically, it focuses on the relationship between following a healthy diet, weight loss and diabetes, as obesity has repeatedly appeared as one of the leading causes of diabetes mellitus type II. Table 1 summarizes the critical information used in the PICOT formulation of the research question. Table 1: PICOT variables considered in the study P I C O T Obese adults with a body mass index over 30 Development of an effective weight loss strategy The control group in the study should not follow any weight loss strategy Lower risk of diabetes mellitus type II One year The research question taking this information into account is: “Is there any evidence-based of how losing weight reduces the risk of diabetes mellitus type II in adults showing a body mass index higher than 30 before it is too late?” PICOT RESEARCH QUESTIONS 3 References Delahanty, L. M., & Nathan, D. M. (2008). Implications of the diabetes prevention program and Look AHEAD clinical trials for lifestyle interventions. Journal of the American Dietetic Association, 108(4), S66-S72. Diabetes Prevention Program (DPP) Research Group. (2002). The Diabetes Prevention Program (DPP): description of lifestyle intervention. Diabetes Care, 25(12), 2165-2171. Franz, M. J., Bantle, J. P., Beebe, C. A., Brunzell, J. D., Chiasson, J. L., Garg, A., … & Purnell, J. Q. (2002). Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care, 25(1), 148-198. PICOT RESEARCH QUESTIONS 4 Franz, M. J., VanWormer, J. J., Crain, A. L., Boucher, J. L., Histon, T., Caplan, W., … & Pronk, N. P. (2007). Weight-loss outcomes: a systematic review and meta-analysis of weight-loss clinical trials with a minimum 1-year follow-up. Journal of the American Dietetic Association, 107(10), 1755-1767. PICOT RESEARCH QUESTIONS 5 Laaksonen, D. E., Lindström, J., Lakka, T. A., Eriksson, J. G., Niskanen, L., Wikström, K., … & Ilanne-Parikka, P. (2005). Physical activity in the prevention of type 2 diabetes: the Finnish diabetes prevention study. Diabetes, 54(1), 158-165. Look AHEAD Research Group. (2003). Look AHEAD (Action for Health in Diabetes): design and methods for a clinical trial of weight loss for the prevention of cardiovascular disease in type 2 diabetes. Controlled clinical trials, 24(5), 610-628.
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