RUBRIC1Unsatisfactory0.002Less than Satisfactory75..docx

RUBRIC
1
Unsatisfactory
0.00%
2
Less than Satisfactory
75.00%
3
Satisfactory
83.00%
4
Good
94.00%
5
Excellent
100.00%
60.0 %Content
5.0 %Nursing Practice Problem and PICOT Statement
A nursing practice problem is not clearly described and/or a
PICOT statement is not included.
PICOT statement describes a nursing practice problem but lacks
reliable sources.
PICOT statement describes a nursing practice problem and
includes a few reliable sources.
PICOT statement articulates a nursing practice problem using
supporting information from reliable sources.
PICOT statement clearly articulates a nursing practice problem
using substantial supporting information from numerous reliable
sources.
5.0 %Background of Study
Background of study including problem, significance to nursing,

purpose, objective, and research questions is incomplete.
purpose, objective, and research questions is included but lacks
relevant details and explanation.
purpose, objective, and research questions is partially complete
and includes some relevant details and explanation.
purpose, objective, and research questions is complete and
includes relevant details and explanation.
purpose, objective, and research questions is thorough with
substantial relevant details and extensive explanation.
5.0 %Method of Study
Discussion of method of study including discussion of
conceptual/theoretical framework is incomplete.
conceptual/theoretical framework is included but lacks relevant
details and explanation.
conceptual/theoretical framework is partially complete and
includes some relevant details and explanation.
conceptual/theoretical framework is complete and includes
conceptual/theoretical framework is thorough with substantial
relevant details and extensive explanation.
5.0 %Results of Study
Discussion of study results including findings and implications
for nursing practice is incomplete.
for nursing practice is included but lacks relevant details and
explanation.

for nursing practice is partially complete and includes some
for nursing practice is complete and includes relevant details
and explanation.
for nursing practice is thorough with substantial relevant details
and extensive explanation.
5.0 %Ethical Considerations
Discussion of ethical considerations associated with the conduct
of nursing research is incomplete.
of nursing research is included but lacks relevant details and
explanation.
of nursing research is partially complete and includes some
of nursing research is complete and includes relevant details
and explanation.
of nursing research is thorough with substantial relevant details
and extensive explanation.
5.0 %Conclusion
Conclusion does not summarize a critical appraisal and
applicability of findings.
Conclusion is vague and does not discuss importance to nursing.
Conclusion summarizes utility of the research and importance to
nursing practice.
Conclusion summarizes utility of the research from the critical
appraisal and the findings importance to nursing practice.
Conclusion summarizes utility of the research from the critical
appraisal, knowledge learned, and the importance of the

findings to nursing practice.
10.0 %Evidence of Revision
Final paper does not demonstrate incorporation of feedback or
evidence of revision on research critiques.
Incorporation of research critique feedback or evidence of
revision is incomplete.
Incorporation of research critique feedback and evidence of
revision are present.
Evidence of incorporation of research critique feedback and
revision is clearly provided.
Evidence of incorporation of research critique feedback and
revision is comprehensive and thoroughly developed.
10.0 %PICOT Statement, Research Article, and Nursing
Practice Problem Link (C. 2.2)
Discussion of the link between the PICOT statement, research
articles, and nursing practice problem is not included.
articles, and nursing practice problem is incomplete or
incorrect.
articles, and nursing practice problem is included but lacks
relevant details and supporting explanation.
articles, and nursing practice problem is complete and includes
relevant details and supporting explanation.
articles, and nursing practice problem is extremely thorough
with substantial relevant details and extensive supporting
explanation.
10.0 %Proposed Evidence-Based Practice Change (C. 3.2)
The proposed evidence-based practice change is not included.
The proposed evidence-based practice change is incomplete or
incorrect.

articles, and nursing practice problem is included but lacks
relevant details and supporting explanation. The proposed
evidence-based practice change is included but lacks supporting
explanation and relevant details.
The proposed evidence-based practice change is complete and
includes supporting explanation and relevant details.
The proposed evidence-based practice change is extremely
thorough and includes substantial supporting explanation and
numerous relevant details.
30.0 %Organization and Effectiveness
10.0 %Thesis Development and Purpose
Paper lacks any discernible overall purpose or organizing claim.
Thesis is insufficiently developed or vague. Purpose is not
clear.
Thesis is apparent and appropriate to purpose.
Thesis is clear and forecasts the development of the paper.
Thesis is descriptive and reflective of the arguments and
appropriate to the purpose.
Thesis is comprehensive and contains the essence of the paper.
Thesis statement makes the purpose of the paper clear.
10.0 %Argument Logic and Construction
Statement of purpose is not justified by the conclusion. The
conclusion does not support the claim made. Argument is
incoherent and uses noncredible sources.
Sufficient justification of claims is lacking. Argument lacks
consistent unity. There are obvious flaws in the logic. Some
sources have questionable credibility.
Argument is orderly, but may have a few inconsistencies. The
argument presents minimal justification of claims. Argument
logically, but not thoroughly, supports the purpose. Sources
used are credible. Introduction and conclusion bracket the
thesis.

Argument shows logical progressions. Techniques of
argumentation are evident. There is a smooth progression of
claims from introduction to conclusion. Most sources are
authoritative.
Argument is clear and convincing and presents a persuasive
claim in a distinctive and compelling manner. All sources are
authoritative.
10.0 %Mechanics of Writing (includes spelling, punctuation,
grammar, language use)
Surface errors are pervasive enough that they impede
communication of meaning. Inappropriate word choice or
sentence construction is used.
Frequent and repetitive mechanical errors distract the reader.
Inconsistencies in language choice (register), sentence
structure, or word choice are present.
Some mechanical errors or typos are present, but they are not
overly distracting to the reader. Correct sentence structure and
audience-appropriate language are used.
Prose is largely free of mechanical errors, although a few may
be present. A variety of sentence structures and effective
figures of speech are used.
Writer is clearly in command of standard, written, academic
English.
10.0 %Format
5.0 %Paper Format (use of appropriate style for the major and
assignment)
Template is not used appropriately or documentation format is
rarely followed correctly.
Template is used, but some elements are missing or mistaken;
lack of control with formatting is apparent.
Template is used, and formatting is correct, although some
minor errors may be present.
Template is fully used; There are virtually no errors in

formatting style.
All format elements are correct.
5.0 %Documentation of Sources (citations, footnotes,
references, bibliography, etc., as appropriate to assignment and
style)
Sources are not documented.
Documentation of sources is inconsistent or incorrect, as
appropriate to assignment and style, with numerous formatting
errors.
Sources are documented, as appropriate to assignment and style,
although some formatting errors may be present.
Sources are documented, as appropriate to assignment and style,
and format is mostly correct.
Sources are completely and correctly documented, as
appropriate to assignment and style, and format is free of error.
100 %Total Weightage
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:
· 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?
Method of Study:
· Were qualitative methods appropriate to answer the research
questions?
· Did the author identify a specific perspective from which the
study was developed? If so, what was it?
· Did the author cite quantitative and qualitative studies
relevant to the focus of the study? What other types of literature
did the author include?
· 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.
· Did the author evaluate or indicate the weaknesses of the
available studies?
· Did the literature review include adequate information to build
a logical argument?
· 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?
Results of Study
· What were the study findings?
· What are the implications to nursing?
· Explain how the findings contribute to nursing
knowledge/science. Would this impact practice, education,
administration, or all areas of nursing?
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.
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
· Identify the benefits and risks of participation addressed by
the authors. Were there benefits or risks the authors do not
identify?
· Was informed consent obtained from the subjects or
participants?
· Did it seem that the subjects participated voluntarily in the
study?
· Was institutional review board approval obtained from the
agency in which the study was conducted?
· Are the major variables (independent and dependent variables)
identified and defined? What were these variables?
· How were data collected in this study?
· What rationale did the author provide for using this data
collection method?
· Identify the time period for data collection of the study.
· Describe the sequence of data collection events for a
participant.
· Describe the data management and analysis methods used in
the study.
· 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?
· 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
· What is the researcher's interpretation of findings?
· Are the findings valid or an accurate reflection of reality? Do
you have confidence in the findings?
· What limitations of the study were identified by researchers?
· Was there a coherent logic to the presentation of findings?
· 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?
· What suggestions are made for further studies?
· 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.
© 2016. Grand Canyon University. All Rights Reserved.
4

Running head: RESEARCH CRITIQUE
1
RESEARCH CRITIQUE
4
Quantitative Research Critique
Grand Canyon University: NRS-433V-0503
Professor: Melissa Petrick
April 22, 2018
Introduction
Current estimates indicate that nearly 50 percent of
persons suffering from diabetes do not attain and sustain the
required target of less than 7 percent for glycated hemoglobin
and a mere 14.3 percent are at the target requirements for
glycated hemoglobin, low density lipoprotein cholesterol, non-
smoking as well as blood pressure. The American Diabetes
Association, through its 2015 standards for patient care,
recognize the impact of diabetes self-management education as
a significant aspect of care for individuals with diabetes.
However, recent studies indicate that among new cases of
diabetes, 7 percent of persons with private insurance and less
than 5 percent of individuals covered by Medicare participate
diabetes self-management education (Chrvala, Sherr & Lipman,
2016). It is for this reason that Tang et al. (2014) conducted a
study on the impacts of peer leaders as well as community
health workers in diabetes self-management support. This paper

is a critique of the aforementioned research by Tang et al.
(2014) in an article titled “Comparative effectiveness of peer
leaders and community health workers in diabetes self-
management support: results of a randomized controlled trial”.
Comment by Melissa Petrick: Put the period inside the
quotation here.
Article Summary Comment by Melissa Petrick: Within
Methods of Study, these questions can be used to guide
analysis. You discussed some of these, but make sure you look
at these questions to analyze deeper.Identify the benefits and
risks of participation addressed by the authors. Were there
benefits or risks the authors do not identify?Was informed
consent obtained from the subjects or participants?Did it seem
that the subjects participated voluntarily in the study?Was
institutional review board approval obtained from the agency in
which the study was conducted?Are the major variables
(independent and dependent variables) identified and defined?
What were these variables?How were data collected in this
study? What rationale did the author provide for using this data
collection method? Identify the time period for data collection
of the study. Describe the sequence of data collection events for
a participant. Describe the data management and analysis
methods used in the study. 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?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?
The purpose of this study was to compare peer leader versus
community health worker telephone outreach program in
sustaining improvements in glycemic control over 1 year after a
half a year diabetes self-management education program. The
sample was random, including 116 adults suffering from DM

type 2 who were recruited via a federally qualified health
center. The research participants were randomized to a 6 month
diabetes self-management education program followed by a 1
year of weekly group sessions administered by peer leaders with
telephone outreach to research participants unable to attend the
program. Also, the randomized study of 6 month diabetes self-
management education program followed by 1 year of monthly
outreach via telephone administered by community health
workers. The main outcome was glycemic control with the
secondary outcomes being the cardiovascular disease risk
factors, diabetes social support as well as diabetes distress.
Assessments were performed at three different baselines- 6, 12
as well as 18 months (Tang et al., 2014). Comment by Melissa
Petrick: Consider grammar check to resolve this.
The researchers found that, after diabetes self-management
support, the group that passed through the peer leadership
program maintained glycemic control improvements for up to 18
months after the education program. Only the peer leader group
maintained the improvements realized in blood pressure for 18
months. The community health workers’ group, on the other
hand, showed a reduction in glycemic control for up to 6 months
after the diabetes self-management education program. A follow
up, 18 months later, showed that the peer leader group and the
community health workers group maintained improvements with
no significance difference in three areas-waist circumference,
diabetes distress as well as diabetes support. In conclusion, the
researchers asserted that low cost maintenance programs-
whether peer leader program or community health worker
program-maintained improvement in major patient reported
diabetes outcomes. Nonetheless, peer leader intervention has
additional advantage in sustaining clinical improvement for
more than 12 months (Tang et al., 2014).
The Relevance of the Study’s Findings in Nursing Practice
The study’s findings are important for nursing practice
since diabetes self-management education has, for many years,
been accepted as an essential aspect of care for persons living

with diabetes and those at risk for developing diabetes. The
Centers for Disease Control and Prevention, in its 2014 data,
show that the incidence and prevalence rates for diabetes are
high among minority communities. This is attributed to the
health care access disparities, which is common among ethnic
and minority groups (CDC, 2014). Adoption of community
health worker initiative model to reduce health care access
disparities to diabetes education is a vital as well as practical
approach, with sufficient evidence supporting its efficacy. The
National Standards for DM Self-Management Support and
Education, fifth standard, acknowledges that case managers,
health educators, community health workers as well as peer
counselors in diabetes self-management education. In particular,
they can contribute effectively as components of DM self-
management education team as well as in providing patients
with diabetes self-management support. People who serve as
community health workers as well as peer counselors can help
in providing diabetes education and self-management
instructions as well as DM sand support if they acquire enough
training in group facilitation, diabetes management, emotional
support and self-management skills (AADE, 2015).
From the diabetes perspective, peers are defined as persons
suffering from diabetes or individuals affected by diabetes like
close family members. Peer support can empower affected
individuals to connect with others with similar experiences,
which can lead to patient satisfaction as well as motivation.
Peer support, from the healthcare point of view is, “the
provision of emotional, appraisal and informational assistance
by a created social network member who possesses experiential
knowledge of specific behavior or stressor and similar
characteristics as the target population” (Werfalli et al., 2015,
p. 2). The researchers indicate that emotional support is the
expression of caring, encouragement, reassurance as well as
empathy and it enhances self-esteem. Informational support is
the provision of advice, alternative actions, suggestions as well
as feedback regarding the issue that a peer is encountering.

Appraisal support, on the other hand, includes encouraging
optimism as well as persistence for problem resolution. It also
relates to affirmation the peer’s feelings and reassurance that he
or she can deal with his or her frustrations. Researchers have
the responsibility of protecting participants in investigations.
Ethics is a basic foundation for conducting effective as
well as meaningful research and, therefore, ethical behavior and
conduct of researchers is under scrutiny. All researchers,
including psychologists, anthropologists and educators, have
four major duties to participants. These include informed
consent, privacy and deception as well as protection from harm.
With regards to informed consent, a researcher must ensure that
research participants have an understanding of the purpose as
well as the methods of the study. Also, it is important to risks
involved as well as the demands placed on them as participants.
The participants must also understand that they have the right to
withdraw from a study at any particular time. From a legal
perspective, informed consent revolves around three basic
aspects: capacity, voluntariness as well as information. These
three elements must be present for an effective informed
consent (Punch, 2013). Comment by Melissa Petrick:
While this is important to understand what ethical
considerations are, this critique looks to discuss if the ethical
considerations were applied to the study you’re critiquing. Was
the study approved by an Institutional Review Board?Was
patient privacy protected?Were there ethical considerations
regarding the treatment or lack of?
Researchers must take appropriate and reasonable steps to
avoid harm to participants and others with whom they operate or
work. The basic concern is ensuring that no one is harmed by
acting as a participant. Harm includes physical pain and death
as well as other factors like psychological stress, humiliation,
myriad influences and personal embarrassment that adversely
affect participants in significant ways. A research must be
planned as well as executed in a way that minimizes harm to

research participants. Studies are more ethically justifiable if
the probabilities of risks are minimized. Also, researchers must
consider the long term effects of the study on participants and
other users (Punch, 2013).
The other ethical consideration is attached to participants’
privacy; privacy is a highly treasured right in Western society.
The final of deception involves intentional misrepresentation of
key facts regarding the purpose, nature and consequences of a
study. Researchers collect and analyze data regarding people,
either as individuals or groups and this is a source of conflict
between a researcher’s goals and the privacy rights. It refers to
the omission and commission of information when interacting
with participants. Therefore, deception has become concern for
researchers (Punch, 2013). Comment by Melissa
Petrick: Put a conclusion here tying it altogether. �
References
American Association of Diabetes Educators. (2015).
Community health workers in diabetes management and
prevention. Maryland, MD: Author
Centers for Disease Control and Prevention. (2014). National
diabetes statistics report: Estimates of diabetes and its
burden in the United States. Atlanta, GA : Author.
Chrvala, C. A., Sherr, D., & Lipman, R. D. (2016). Diabetes
self-management education for adults with type 2 diabetes
mellitus: a systematic review of the effect on glycemic
control. Patient education and counseling, 99(6), 926-943.
Punch, K. F. (2013). Introduction to social research:
Quantitative and qualitative approaches. Thousand Oaks, C A:
sage.
Tang, T. S., Funnell, M., Sinco, B., Piatt, G., Palmisano, G.,
Spencer, M. S., ... & Heisler, M. (2014). Comparative
effectiveness of peer leaders and community health workers in
diabetes self-management support: results of a randomized

controlled trial. Diabetes care, 37(6), 1525-1534.
Werfalli, M., Raubenheimer, P., Engel, M., Peer, N., Kalula, S.,
Kengne., A. P., &Levitt, N. S. (2015). Effectiveness of
community-based peer-led diabetes self-management
programmes (COMP-DSMP) for improving clinical
outcomes and quality of life of adults with diabetes in
primary care settings in low and middle income countries
(LMIC): A systematic review and meta analysis. BMJ Open,
5(007635), 1-8.
Running head: RESEARCH CRITIQUE 1
RESEARCH CRITIQUE 3
Qualitative Research Critique
Professor: Melissa Petrick
April 15, 2018
Research Critique
The development of nursing practice is dependent on the
advancement of new knowledge, which is facilitated by new
research. Evidence-based practice is an important part of
nursing as it helps to ensure that the promotion of healthcare is
based on valid and applicable information. To determine the
validity, credibility, and applicability of research information, it
is required that a research critique is conducted to highlight the
strengths and weaknesses of the study and how they affect the
applicability of the research (LoBiondo-Wood & Haber, 2017).
The following is a critique of the article “Experiences of
diabetes self‐management: a focus group study among

Australians with type 2 diabetes” by Carolan, Holman, and
Ferrari (2015). The critique analyses the study’s background,
methodology, results, and the ethical considerations made by
the researchers. Comment by Melissa Petrick: analyzes
Background of the Study
The study by Carolan, Holman, and Ferrari (2015) was based in
Australia where approximately a million people have been
diagnosed with diabetes. The rate of diabetes in Australia has
more than doubled in the past four decades. Among all the
diabetes cases in the country, 85% of them are Type 2 diabetes
cases, which are mainly caused by lifestyle decisions. Some of
the risk factors for Type 2 diabetes include old age, obesity,
sedentary lifestyle, ethnicity, and low socio-economic status.
People with more than one risk factor have a higher chance of
getting Type 2 diabetes at some point in their life. Diabetes
self-management is an important part of proper diabetes care.
Patients are expected to understand the strategies that they
should take for glycemic control and to change the lifestyle
conditions that contribute to diabetes. However, people in the
low socio-economic conditions may lack the resources and
services to properly manage their condition. Carolan, Holman,
and Ferrari (2015) identified the diabetes issue within the
Australian population and developed a study that aimed to
determine the treatment and care experiences of type 2 diabetes
mellitus patients with reference to access to services and
resources. The study was based in a low socio-economic rea
where the people are likely to have trouble accessing the
resources they need to properly care for their illness. The
following are the research questions that this study was
designed to answer.
· What are the experiences of a diabetes patient in a low socio-
economic setting?
· How does diabetes affect a patient and their family?
· What difficulties do diabetes in low socio-economic areas
experience?
The purpose and the research questions of this study relate to

the study problem because they are focused on the difficulties
that the low socio-economic groups in Australia experience. The
problem identified that there is a large number of people in
Australia with type 2 diabetes and the people in the low-socio
economic groups have a higher risk of having diabetes.
Method of Study
The study was conducted using an exploratory qualitative
research design. The research data was collected in the form of
focus groups made up of a population of 22 people aged
between 40 and 70 years, with type 2 diabetes. There was
different focus groups ranging from four to eight participants
each where the data was recorded, transcribed, and later
analyzed using a thematic analysis approach. Although Carolan,
Holman, and Ferrari (2015) do not create the exact framework
to demonstrate the use of grounded theory, the research process
shows that they used a valid process of research.
The qualitative methods that have been used in this study were
appropriate in studying the research questions. This was an
exploratory study, meaning that there was no definite
hypothesis that the researchers were investigating. Therefore,
investigating the research problem with a focus group was a
good technique of identifying a variety of information, which
was later used in the development of the themes.
In developing this study, Carolan, Holman, and Ferrari (2015)
cited various qualitative and quantitative research sources to
enhance the validity of the claims that have been made in the
study. The sources that have been cited tend to include both
recent and slightly old studies. The oldest research cited by the
authors was published in 1999, while the most recent was
published in 2015. However, the older researches used in this
study are only focused on developing the methodology. The
literature review of the article only focuses on the more recent
studies, which are a more accurate representation of developed
facts at the time of the development of the article. As for the
older citations, it is highly unlikely that research methods have
changed too much to affect the validity of the information

included by the researcher. In general, the literature review
developed in this study builds a valid argument. It shows the
gap in understanding the struggles that low income type 2
diabetes patients undergo and the need for new information to
develop better care for the poorer diabetes patients in Australia.
The research does not list the limitations that were experienced
in the research process.
Results of Study
From the data collected from the focus groups, various themes
were developed. These themes include the patients’ personal
journey, diabetes as a silent disease, the access to services and
resources, and the work of managing diabetes. The researchers
found that diabetes patients experience emotional, physical, and
social challenges. This study highlighted the impact that
diabetes has on the individual and their family and the
importance of having a family support system to assist in the
self-management efforts. The study concluded that the
participants were generally satisfied with their current care but
there was a clear need for self-management education to provide
additional information on the understanding of this condition.
The results of this study have some implications on the
development of nursing practice and nursing research. This
study has demonstrated that people in the low socio-economic
environments have unique challenges that need to be addressed
to improve the quality of service and care that they receive.
This was an exploratory study; hence, it can be used as a basis
for more in-depth studies that investigate the specific themes
that have been identified. Possibly, this can help in the
development of new information that can improve diabetes self-
management.
Carolan, Holman, and Ferrari (2015) took various steps to make
sure that their study was ethical. This study was reviewed by an
IRB and was approved before its commencement. The ethical
consideration that has been made in the study is the protection
of the privacy of the participants. The researchers used

pseudonyms in place of the real identities of the participants to
protect their privacy. Additionally, the researchers obtained a
written consent from the participants before they participated in
the focus groups. The participants voluntarily left their details
and results of the study were mailed to them after the
completion of the analysis.
Conclusion
The study by Carolan, Holman, and Ferrari (2015) has utilized
some relevant quantitative techniques to ensure that the study is
valid and applicable. The study has a clear aim and uses valid
qualitative techniques to meet the research objectives. Valid
research sources and methodology has been used in performing
this research. From this analysis, it is clear that this is a valid
study that can be applied in developing new knowledge for
nursing practice. Through the study, one can develop new
researches that can help to develop self-management care for
diabetic patients.
References
Carolan, M., Holman, J., & Ferrari, M. (2015). Experiences of
Australians with type 2 diabetes. Journal of clinical
nursing, 24(7-8), 1011-1023. Comment by Melissa Petrick:
“Clinical Nursing” should be capitalized.
LoBiondo-Wood, G., & Haber, J. (2017). Nursing Research-E-
Book: Methods and Critical Appraisal for Evidence-Based
Practice. Elsevier Health Sciences.
Running head: PICOT AND LITERATURE SEARCH 1
PICOT AND LITERATURE SEARCH 6

Diabetes: PICOT Statement and Literature Search
Professor: Melissa Petrick Comment by Melissa Petrick:
Double check GCU APA paper formatting. Does this need to be
included?
April 8, 2018
Diabetes: PICOT Statement and Literature Search
PICOT Statement
PICOT Statement: Adults with Type 1 and Type 2 Diabetes
undergoing self-management education compared to not
undergoing self-management education can achieve better
glycemic control within six months. Comment by Melissa
Petrick: All the resources refer to type 2 that I saw in the
abstract. Your PICOT question below only has type 2 in it as
well.
P: - Population - Adults with Type 1 and Type 2 Diabetes
I: - Intervention - Undergoing self-management education
C: - Comparison - Not undergoing self-management education
O: - Outcome - Can achieve better glycemic control
T: - Time - Six months
Does educating patients on the risk of developing type 2 DM, if
lifestyle changes do not occur, reduce the risk for developing
DM compared to patients who do not receive education?
Comment by Melissa Petrick: From what I saw, your
research looked like it aimed to study the effects of self-
management on overall health/patient perceptions/a1c levels.
However, I didn’t see data that linked self-
management/education tools on pre-diabetes and reduction of
development of type 2 DM. I might have missed that there’s
data embedded in the articles beyond the abstracts, but keep this
in mind as you critically think of this topic.

References
Carolan, M., Holman, J., & Ferrari, M. (2015). Experiences of
Australians with type 2 diabetes. Journal of clinical
nursing, 24(7-8), 1011-1023. Comment by Melissa Petrick:
Look at capitalization here in the journal name. Is this an
electronic resource? Does it have a doi or URL?
The aim of this study is to explore the experiences and concerns
of type 2 diabetes patients in a low socio-economic
environment. The researchers performed an exploratory
qualitative study with a focus group of 22 people aged between
40 and 70 with type 2 diabetes mellitus. The data collected from
this focus group study was analyzed using a thematic analysis
approach. The participants of the group described their
experiences and they were categorized as physical, emotional,
and psychological. The data analysis showed four main themes
in the experiences of the patients including personal journey,
diabetes the silent disease, access to resources and services, and
the work of managing diabetes. The research subjects
highlighted that the impact of the diabetes management is not
only on the patient but also the support group that assists in the
self-management efforts. In conclusion, he members of this
study are generally satisfied with their self-management
techniques but they are in need of additional information to
understand more about their condition.
Chrvala, C. A., Sherr, D., & Lipman, R. D. (2016). Diabetes
self-management education for adults with type 2 diabetes
mellitus: a systematic review of the effect on glycemic
control. Patient education and counseling, 99(6), 926-943.
The purpose of this article is to determine the effect of self-
management education and the support methods, duration, and

contact time or glycemic control for patients of type 2 diabetes.
The researchers used online databases such as MEDLINE,
ERIC, CINAHL, EMBASE and PsycINFO for article that assess
diabetes interventions that involve patients’ participation in
self-management activities. The review assessed 118 unique
intervention techniques with 61.9% reporting significance. The
overall mean reduction in A1C was 0.74 for the study groups
and 0.17 for the control groups. A combination of individual
and group engagement groups had the largest decreases in A1C
with 0.88. Patients with elevated glycemic values reported a
statistically significant reduction in their A1C with 83.9%. The
data of this study suggests that the mode of self-management
education delivery, the hours of engagement, and the baseline
glycemic level affect the significant achievement in glycemic
control after diabetes self-management.
Milajerdi, A., Shab-Bidar, S., Azizgol, A., & Khosravi-
Boroujeni, H. (2015). Provision of nutritional/lifestyle
counseling on diabetes self-management: A chance to improve
metabolic control in new cases of type 2 diabetes. Journal of
Nutritional Sciences and Dietetics, 1(2), 98-106.
The purpose of this study was to evaluate the efficacy of self-
management education on metabolic control for type 2 diabetes
patients. This was a quasi-experimental study that was done
with 300 type 2 diabetes patients as the primary research
subjects. The patients participated in 16-week educational
program where they were trained on metabolic control by a
dietician. At baseline, there was an intervention group attending
a 20 minute lifestyle and nutrition educational program. The
participants were analyzed at baseline and a 2 to 4 months
follow-up for changes in the glycemic status, BMI, and lipid
profile were done. Later a pre-education and post education
analysis of variance was done to evaluated the differences. This
study found that a lifestyle and nutrition education program
were effective in helping patients of type 2 diabetes to improve
their metabolic control. This study suggested that metabolic
control can be done through educational intervention rather that

the pharmacological interventions.
Nasab, M. N., Ghavam, A., Yazdanpanah, A., Jahangir, F., &
Shokrpour, N. (2017). Effects of self-management education
through telephone follow-up in diabetic patients. The health
care manager, 36(3), 273-281.
The aim of this study was to investigate the effect of self-
management education with a telephone follow-up for diabetic
patients living in rural areas of Iran. The study was done using
an experimental study design with 64 participants randomly
assigned to the intervention and control groups of 32 each. The
intervention group included patients who attended four
educational sessions lasting 90 minutes each. The control group
went through the traditional care routine. The outcome of the
experinment was measured using the Diabetes Self-Managemnt
Questionnaire (DSMQ) before and after the intervention. The
results were analysed using Mann-Whitney U tests. The results
found that there was a significant difference in the glycemic
control for the intervention and control groups. This study
suggests that self-management education facilitates better self-
care.
Pereira, K., Phillips, B., Johnson, C., & Vorderstrasse, A.
(2015). Internet delivered diabetes self-management education:
a review. Diabetes technology & therapeutics, 17(1), 55-63.
The purpose of this article was to investigate the effectiveness
of internet-delivered diabetes self-management education on
glycemic control. A quantitative analysis was done on literature
from various online databases such as PubMed, EBSCO,
CINAHL, and Web of Science. The search led to the analysis of
111 relevant articles, but only 14 met the criteria for the review.
Nine of the reviewed articles were randomized control trials
with study lengths varying between 2 weeks and 24 months. The
results of the study showed that internet delivered self-
management education is effective in reducing glycemic control
among diabetes patients. Additionally, the results showed that
self-management education help to increase rates if clinical
attendance and change eating habits after the online engagement

with patients through the internet. The implications of this
study are that education on self-management techniques can be
offered through online platforms and help improve self-care
among diabetes patients.
Tang, T. S., Funnell, M., Sinco, B., Piatt, G., Palmisano, G.,
Spencer, M. S., ... & Heisler, M. (2014). Comparative
effectiveness of peer leaders and community health workers in
diabetes self-management support: results of a randomized
controlled trial. Diabetes care, 37(6), 1525-1534.
The objective of this article was to compare the differences
between the effects of a peer leaders versus community health
worker led telephone outreach intervention compared to a six
months self-management education program. The study was
done using a randomized control trial with 116 Latino adults
with type 2 diabetes. The participants were selected from a
federally qualified health center and randomly selected for a 6-
month self-management education program followed by 12
months of weekly group discussions delivered by peer leaders.
Another group was enrolled for the 6-moth education program
and later a 12 month outreach program by a community health
worker. The results suggested that the group that underwent the
peer leadership groups maintained their improvements after the
education program for a period of 18 months. Both groups
maintained their improvements in waist circumference, diabetes
distress, and diabetes support with no significant differences
between each of the groups. This study suggests that both low
cost peer group interventions and community health worker led
outreach programs help diabetes patients to maintain their
diabetes management after their education program.

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