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NURS 6540 (Walden University)Week 6 AssignmentPICO Analysis of Dementia, Delirium, and Depression.
2 pages Instructions..
Assignment 1: 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.
By Day 7 of Week 6
This Assignment is due.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
Please save your Assignment using the following naming convention: “WK6Assgn1+lastname+first initial”.
Click the Week 6 Assignment 1 link.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK6Assgn1+last name+first initial.(extension)” and click Open. If you are submitting multiple files, repeat until all files are attached.
Click on the Submit button to complete your submission.
Note: References: From Joournals ( recent 5 years ) 2014 to present. No resources ending in ".com"
| Subject | Nursing | Pages | 9 | Style | APA |
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Answer
PICO Analysis of Depression Management
Part I: PICO (Patient/Population, Intervention, Comparison, and Outcome) Question
In depression patients (P), is electroconvulsive therapy (I) more effective than pharmacotherapy (C) in relieving of depressions symptoms (O)?
Part II: Search Strategy
To provide evidence-based and credible response to the PICO question above, peer-reviewed journal articles published from 2014 to 2020 were utilized as sources of evidence. Search terms that were exploited in search of sources of evidence include electroconvulsive therapy AND pharmacotherapy for depression, ECT versus medications for depression, and depression medications AND electroconvulsive therapy. Articles for review and analysis were retrieved from databases/websites such as the Walden Library, BMC Psychiatry, National Center for Biotechnology Information, Oxford Academic, PubMed Central, Advanced Biomedical Research, and Cochrane Library. Five articles were identified for review and analysis. Refer to Table 1 below. The identified articles were all primary sources of evidence and included a systematic review and meta-analysis article (Song et al., 2015), and the other four articles are peer-reviewed primary articles.
Part III: Analysis of Literature
Table 1: Literature Review Matrix
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Author/ Date |
Theoretical/ Conceptual Framework |
Research Question(s)/ Hypotheses |
Methodology |
Analysis & Results |
Conclusions |
Implications for Future research |
Implications For practice |
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Oltedal et al. (2015).
Summary of Evidence and Recommended Appropriate Treatment Options for Depression ECT is more effective than antidepressants in relieving symptoms of treatment-resistant depression. There is no significant difference in terms of effectiveness when ECT is employed alone or in combination with antidepressants; therefore, ECT should preferably be used alone (Song et al., 2015). In fact, ECT has been found to have a superior effect in terms of shorter period of resolving symptoms of a major depressive disorder and improving quality of life compared to fluoxetine (Lin, Huang, & Chen, 2018). In terms of cost-effectiveness of care, use of ECT as a first-line intervention for management of treatment-resistant major depressive disorders is found to be not cost-effective compared to pharmacotherapy and/or psychotherapy. Therefore, it is optimally cost-effective to use ECT when two or more lines of psychotherapy and/or pharmacotherapy have failed (Ross, Zivin, & Maixner, 2018). A part from cost concerns, ECT should be used with caution since it may be harmful to brain structure and/or function, but the findings are not conclusive. There is a need for further research on this (Oltedal et al., 2015). Another study by Kheirabadi et al. (2019) found that ECT has similar efficacy as intravenous ketamine in treatment of major depression and each does not cause any memory loss.
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Effects of ECT in treatment of depression: study protocol for a prospective neuroradiological study of acute and longitudinal effects on brain structure and function compared with standard treatment. |
What are the harmful effects or side effects of ECT use in treatment of depression compared with standard treatment? |
Use of advanced magnetic resonance imaging to investigate functional and structural brain effects. |
Correlating MRI findings with multidisciplinary investigation of neuropsychological functioning, psychiatric response parameters, genetic biomarkers and neurochemical biomarkers.
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ECT may have harmful brain effects to the structure and function of the brain compared with standard medication treatment; however, the findings are not conclusive. |
Potential harmful effects of ECT may result in new prospect in future research. |
Effects of ECT on the brain need to be better understood. |
References
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Kheirabadi, G., Vafaie, M., Kheirabadi, D., Mirloudi, Z., & Hajiannasab, R. (2019).Comparative effect of intravenous ketamine and electroconvulsive therapy in major depression: a randomized controlled trial. Advanced Biomedical Research, 8(25), 1-9. DOI: 10.4103/abr.abr_166_18. Lin, C-H., Huang, C-J., & Chen, C-C. (2018). ECT has greater efficacy than fluoxetine in alleviating the burden of illness for patients with major depressive disorder: A Taiwanese pooled analysis. International Journal of Neuropsychopharmacology, 21(1), 63-72. DOI:10.1093/ijnp/pyx114. Oltedal, L., Kessler, U., Ersland, L., Gruner, R., Andreassen, O.A., Haavik, J., Hoff, P.I., Hammar, A., Dale, A.M., Hugdahl, K., & Oedegaard, K.J. (2015). Effects of ECT in treatment of depression: study protocol for a prospective neuroradiological study of acute and longitudinal effects on brain structure and function. BMC Psychiatry, 15(94), 1-10. DOI 10.1186/s12888-015-0477-y. Ross, E.L., Zivin, K., & Maixner, D. (2018). Cost-effectiveness of electroconvulsive therapy vs pharmacotherapy/psychotherapy for treatment-resistant depression in the United States. JAMA Psychiatry, 75(7), 713-722. DOI: 10.1001/jamapsychiatry.2018.0768. Song, G-M., Tian, X., Shuai, T., Yi, L-J., Zeng, Z., Liu, S., Zhou, J-G., & Wang, Y. (2015). Treatment of adults with treatment-resistant depression: Electroconvulsive therapy plus antidepressant or electroconvulsive therapy alone? Evidence from an indirect comparison meta-analysis. Medicine, 94(26), 1-14. DOI: 10.1097/MD.0000000000001052.
Appendix
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