Essay Grade

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Running head: PICOT STATEMENT AND LITERATURE SEARCH
PICOT STATEMENT AND LITERATURE SEARCH
Jessica Mock
NRS-433V Grand Canyon University
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PICOT & LITERATURE
Can children with mental disabilities have better health outcomes in adulthood if they are
managed upon early detection vs later detection? Does early intervention truly impact health or
does mental disability have the same outcome despite the starting point of interventional
therapies?
P- Population, patient, problem
Children that have mental disabilities such as autism, delayed speech or functions, ADHD, or
any type of dysfunction found in these children in which some may be diagnosed early and
receive treatment where some may not be diagnosed until late childhood or into school age
stages. Is there a difference in health in adulthood if both are receiving care but at different
points?
I – Intervention
Interventions will depend on diagnosis, stage, level of health disparity. Educational
interventions, therapies, medications, treatments, programs
C – Comparison
Children who receive early diagnosis and intervention vs children that go longer with no
diagnosis or delayed diagnosis and delayed interventions
O – Outcome
Is there a difference or what is the impact in health behaviors in adulthood based on timing of
diagnosis and interventions between children?
T – Time
These are impacts that can be seen later in adolescence into early adulthood
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PICOT & LITERATURE
Rutherford, M., McKenzie, K., Forsyth, K., McCartney, D., O, H. A., McClure, I., & Irvine, L.
(2016). Why are they waiting? Exploring professional perspectives and developing solutions to
delayed diagnosis of autism spectrum disorder in adults and children. Research in Autism
Spectrum Disorders, 31, 53–65. https://doi-org.lopes.idm.oclc.org/10.1016/j.rasd.2016.06.004
Abstract
This mixed method study enhances knowledge of the reason’s professionals give for
delay in diagnostic assessment of autism spectrum disorders.•The study
translates research evidence into practical application through action plans for ASD
services.•The paper presents an Action Plan for child diagnostic teams to improve
efficiency and quality of the diagnostic assessment process.•The paper presents an Action
Plan for adult diagnostic teams to improve efficiency and quality of the diagnostic
assessment process.
Background This paper reports on the development of child and adult Action Plans for
Autism Spectrum Disorder to address the problem of delayed diagnosis and lengthy
waiting times. Evidence used in the development of action plans was gathered from a
sequential mixed methods study to further understand the reasons for the long waiting
time and potential solutions. This is the first published investigation, from the perspective
of diagnosing professional teams, of the reasons for delays, which also generates
solutions.
Methods Ninety- five clinicians from 8 child and 8 adult services attended 16 focus
groups to explore clinicians’ views on a) reducing the wait for diagnosis and b) providing
a good quality diagnostic process with good adherence to clinical guidelines. During
focus groups, quantitative data were fed back, used to frame discussions and facilitate
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PICOT & LITERATURE
solution focused action planning with each service. Sixteen local action plans were
synthesized to create an ASD Action Plan for children and an ASD Action Plan for
adults.
Results Key solutions are proposed to support the reduction of the wait for diagnostic
assessment, through reducing non-attendance rates, reducing inappropriate referrals,
developing efficient working and communication and improving the effectiveness of care
pathways. These are presented in actions plans for use by clinical teams.
Conclusion The first step in addressing the clinical challenge of increased wait for
diagnostic assessment of ASD is understanding the complex and multi-factorial reasons
for delays. The action plans developed here through systematic enquiry and synthesis
may provide clinical diagnostic teams with evidence -based guidance on common
challenges and solutions to guide future quality improvement programs.
Future research to evaluate whether using Action Plans leads to a reduction in waiting
times would be of value.
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PICOT & LITERATURE
Zheng, Y., Maude, S. P., Brotherson, M. J., & Merritts, A. (2016). Early Childhood Intervention
in China from the Families’ Perspective. International Journal of Disability, Development &
Education, 63(4), 431–449. https://doi-org.lopes.idm.oclc.org/10.1080/1034912X.2015.1124988
Abstract
Research highlights the importance of early childhood intervention (ECI)
for children with disabilities, and there is an increasing interest in China with respect
to research on ECI. However, little research exists exploring the experience of families
of young children with disabilities receiving ECI services and supports in China. The purpose
of this study was to understand the ECI experiences of families of such children. A qualitative
research design was used, and data were collected through interviews with six families in
southwest China. This study indicated that, although China has made some progress in ECI
for young children with disabilities, progress in this area is still at an early stage of
development. Many issues still need to be addressed, including knowledge about typical and
atypical development, early identification, professional development, increased government
investment, and better implementation of existing laws. [ABSTRACT FROM AUTHOR]
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PICOT & LITERATURE
Richards, M., & Vostanis, P. (2004). Interprofessional perspectives on transitional mental health
services for young people aged 16 – 19 years. Journal of Interprofessional Care, 18(2), 115–128.
https://doi-org.lopes.idm.oclc.org/10.1080/13561820410001686882
Abstract
This qualitative study investigated the need for transitional mental health services
for young people aged 16 – 19 years in a health district, as perceived by professionals
from mental health, social, education and non-statutory services. Semi-structured interviews
with 39 managers and practitioners who planned or provided services for this age range, from a
wide range of agencies, explored issues related to older adolescents’ needs, service
communication, transfer arrangements, current gaps, and recommendations. Interviews were
transcribed verbatim and themes emerged according to grounded theory. The four identified
themes, with 21 categories, were: (i) older adolescents have multi-faceted needs, (ii)
statutory mental health services are not geared towards this age group, (iii) communication
between services is variable, and (iv) there are no formal transfer arrangements from child to
adult services. The findings support the need for specialist transitional services, and the adoption
of an interprofessional service model incorporating education, social services and nonstatutory
agencies. [ABSTRACT FROM AUTHOR]
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PICOT & LITERATURE
Chakraborty, S., Sagar Kommu, J. V., Srinath, S., Seshadri, S. P., & Girimaji, S. C. (2014). A
Comparative Study of Pathways to Care for Children with Specific Learning Disability and
Mental Retardation. Indian Journal of Psychological Medicine, 36(1), 27. Retrieved from
https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=edb
&AN=94741876&site=eds-live&scope=site
Abstract
Context: Early intervention in specific learning disability (SpLD) results in better outcome and
prevents comorbidity. Understanding the pathways is therefore important. Aims: To study and
compare the pathways to care for children with SpLD and mental retardation (MR) before
reaching a tertiary care center. Settings and Design, Material and Methods: A cross-sectional
study was conducted for pathways to care of two groups: SpLD and MR with 50 children in each
group from 8 to 16 years. MINI-KID for comorbidity and Goldberg’s pathway to care instrument
was used. The groups were divided into early contact (up to three carers) and late contact (more
than three carers) and compared. Statistical Analysis: Data were analyzed using Statistical
Packages for Social Sciences (SPSS) version 10.0 software. Results: Majority (n = 24 or 48%) of
SpLD children visited “others” (teachers, neighbors, relatives, and guardians of fellow
classmates) as first carer. Allopathic practitioners were the first choice for MR children (n = 31
or 62%). Six children (12%) in SpLD group and 10 of MR (20%) group have seen either
traditional practitioner or healer as first carer. Maximum referral to the tertiary center in both
groups was done by others (62% in SpLD and 56% in MR group). Early contacts in SpLD group
belonged to younger age group (P = 0.01). While comparing both groups on the basis of early
and late contact, mother’s education was found to be significant in early contact group (P =
0.036) and having comorbidity was significant among late contacts (P = 0.038). Conclusions:
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PICOT & LITERATURE
The pathways to care for SpLD children are more or less similar to MR children whose parents
recognize MR late. Both the groups visit multiple carers including traditional healers
substantiating the strong belief for supernatural causation of developmental disorders in India.
[ABSTRACT FROM AUTHOR]
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PICOT & LITERATURE
Baglama, B., & Demirok, M. S. (2016). Determination of Preservice Special Education
Teachers’ Views on Early Childhood Intervention. Cypriot Journal of Educational
Sciences, 11(4), 213–222. Retrieved from
https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=eric
&AN=EJ1140744&site=eds-live&scope=site
Abstract
Experiences in early childhood have a great influence on a child’s physical and mental
development. Early childhood interventions are widely accepted as an effective way to prevent
learning difficulties and to promote healthy development for children with special needs. For this
reason, it is important for teachers who will work with children with special needs or children
who are at risk to have sufficient knowledge about early childhood intervention and be
competent in this area. Therefore, the present study aims to determine the views of preservice
special education teachers about early childhood intervention. This study
used quantitative research method and a questionnaire form was used to collect the data. The
results are discussed in detail with reference to relevant literature. Implications and
recommendations for further research are also provided in order to improve the quality of
education policies, programs and practices related with early childhood intervention and increase
awareness and knowledge related with early childhood interventions among teacher candidates.
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PICOT & LITERATURE
Frey, G. C., Temple, V. A., & Stanish, H. I. (2017). Interventions to promote physical activity
for youth with intellectual disabilities. Salud Pública de México, 59(4), 437. Retrieved from
https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=edb
&AN=124408973&site=eds-live&scope=site
Abstract
Objective. To describe interventions designed to promote physical activity for youth with
intellectual disabilities. Materials and methods. A systematic review of nine databases until
January 31, 2015 identified 213 citations. The inclusion criteria were: a) the study sample
consisted of youth with intellectual disabilities, b) the study implemented an intervention to
initiate, increase, or maintain physical activity, and c) quantitative or qualitative data were used
to report the effectiveness of the intervention. Eleven articles from the 213 citations met this
criterion. Results. Nine studies reported significant increases in physical activity behavior.
Conclusions. Conclusions cannot be made regarding intervention components that impacted
outcome variables, if the observed effects were specifically due to the intervention or if
interventions could be maintained long-term. To advance the knowledge base in this area, a
concerted effort should be made to increase rigor in study conceptualization
and research design. [ABSTRACT FROM AUTHOR]
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PICOT & LITERATURE
Temple, V. A., Frey, G. C., & Stanish, H. I. (2017). Interventions to promote physical activity
for adults with intellectual disabilities. Salud Pública de México, 59(4), 446. Retrieved from
https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=edb
&AN=124408974&site=eds-live&scope=site
Abstract
Objective. To describe interventions designed to promote physical activity for adults with
intellectual disabilities and the effects on overall physical activity levels and on health outcomes.
Materials and methods. A systematic review of eight databases until January 31, 2015 identified
383 citations. The inclusion criteria were: a) the study sample consisted of adults with
intellectual disabilities, b) the study implemented an intervention to initiate, increase, or
maintain physical activity, and c) quantitative or qualitative data were used to report the
effectiveness of the intervention. Six articles from the 383 citations met this criterion. Results.
Three studies resulted in significant increases in physical activity behavior; however wellcontrolled trials designed to improve weight status by increasing physical activity did not
produce significant effects. Conclusion. Overall, the results indicate that interventions to increase
physical activity should simultaneously target the individual with intellectual disability as well
as their proximal environment over a sustained period of time. [ABSTRACT FROM AUTHOR]
Research Critique Guidelines
To write a critical appraisal that demonstrates comprehension of the research study conducted,
address each component below for qualitative study in the Topic 2 assignment and the
quantitative study in the Topic 3 assignment.
Successful completion of this assignment requires that you provide a rationale, include examples,
or reference content from the study in your responses.
Qualitative Study
Background of Study:
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Identify the clinical problem and research problem that led to the study. What was not
known about the clinical problem that, if understood, could be used to improve health
care delivery or patient outcomes? This gap in knowledge is the research problem.
•
How did the author establish the significance of the study? In other words, why should
the reader care about this study? Look for statements about human suffering, costs of
treatment, or the number of people affected by the clinical problem.
•
Identify the purpose of the study. An author may clearly state the purpose of the study or
may describe the purpose as the study goals, objectives, or aims.
•
List research questions that the study was designed to answer. If the author does not
explicitly provide the questions, attempt to infer the questions from the answers.
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Were the purpose and research questions related to the problem?
Method of Study:
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Were qualitative methods appropriate to answer the research questions?
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Did the author identify a specific perspective from which the study was developed? If so,
what was it?
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Did the author cite quantitative and qualitative studies relevant to the focus of the study?
What other types of literature did the author include?
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Are the references current? For qualitative studies, the author may have included studies
older than the 5-year limit typically used for quantitative studies. Findings of older
qualitative studies may be relevant to a qualitative study.
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Did the author evaluate or indicate the weaknesses of the available studies?
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Did the literature review include adequate information to build a logical argument?
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When a researcher uses the grounded theory method of qualitative inquiry, the researcher
may develop a framework or diagram as part of the findings of the study. Was a
framework developed from the study findings?
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Results of Study
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What were the study findings?
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What are the implications to nursing?
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Explain how the findings contribute to nursing knowledge/science. Would this impact
practice, education, administration, or all areas of nursing?
Ethical Considerations
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Was the study approved by an Institutional Review Board?
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Was patient privacy protected?
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Were there ethical considerations regarding the treatment or lack of?
Conclusion
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Emphasize the importance and congruity of the thesis statement.
•
Provide a logical wrap-up to bring the appraisal to completion and to leave a lasting
impression and take-away points useful in nursing practice.
•
Incorporate a critical appraisal and a brief analysis of the utility and applicability of the
findings to nursing practice.
•
Integrate a summary of the knowledge learned.
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Quantitative Study
Background of Study:
•
Identify the clinical problem and research problem that led to the study. What was not
known about the clinical problem that, if understood, could be used to improve health
care delivery or patient outcomes? This gap in knowledge is the research problem.
•
How did the author establish the significance of the study? In other words, why should
the reader care about this study? Look for statements about human suffering, costs of
treatment, or the number of people affected by the clinical problem.
•
Identify the purpose of the study. An author may clearly state the purpose of the study or
may describe the purpose as the study goals, objectives, or aims.
•
List research questions that the study was designed to answer. If the author does not
explicitly provide the questions, attempt to infer the questions from the answers.
•
Were the purpose and research questions related to the problem?
Methods of Study
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Identify the benefits and risks of participation addressed by the authors. Were there
benefits or risks the authors do not identify?
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Was informed consent obtained from the subjects or participants?
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Did it seem that the subjects participated voluntarily in the study?
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Was institutional review board approval obtained from the agency in which the study was
conducted?
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Are the major variables (independent and dependent variables) identified and defined?
What were these variables?
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How were data collected in this study?
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What rationale did the author provide for using this data collection method?
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Identify the time period for data collection of the study.
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Describe the sequence of data collection events for a participant.
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Describe the data management and analysis methods used in the study.
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Did the author discuss how the rigor of the process was assured? For example, does the
author describe maintaining a paper trail of critical decisions that were made during the
analysis of the data? Was statistical software used to ensure accuracy of the analysis?
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What measures were used to minimize the effects of researcher bias (their experiences
and perspectives)? For example, did two researchers independently analyze the data and
compare their analyses?
Results of Study
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What is the researcher’s interpretation of findings?
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Are the findings valid or an accurate reflection of reality? Do you have confidence in the
findings?
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What limitations of the study were identified by researchers?
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Was there a coherent logic to the presentation of findings?
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What implications do the findings have for nursing practice? For example, can the
findings of the study be applied to general nursing practice, to a specific population, or to
a specific area of nursing?
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What suggestions are made for further studies?
Ethical Considerations
•
Was the study approved by an Institutional Review Board?
•
Was patient privacy protected?
•
Were there ethical considerations regarding the treatment or lack of?
Conclusion
•
Emphasize the importance and congruity of the thesis statement.
•
Provide a logical wrap-up to bring the appraisal to completion and to leave a lasting
impression and take-away points useful in nursing practice.
•
Incorporate a critical appraisal and a brief analysis of the utility and applicability of the
findings to nursing practice.
•
Integrate a summary of the knowledge learned.
Reference
Burns, N., & Grove, S. (2011). Understanding nursing research (5th ed.). St. Louis, MO:
Elsevier.
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