The clinical problem that will be considered in the proposed research consists of the challenge of suicide prevention in older patients, especially those suffering from terminal illnesses. In general, suicidal thoughts in older people can be viewed as a significant health concern; for example, in the US, over 6,000 older people commit suicide per year, and illnesses are proved to be a major predictor of such events (Conwell, 2014). Therefore, the prevention of suicide in the population is a major concern and aim of modern healthcare, and the proposed study intends to test an intervention that can assist in resolving the issue.
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The proposed study is going to be community-based, which defines its settings as those of my community; the population includes the older patients with the early stages of terminal illnesses who live in the community. People are typically viewed as older adults after the age of 65 (Conwell, 2014), and this criterion can be used to determine potential participants. It is noteworthy that the population is a vulnerable one (Coburn, Marcantonio, Lazansky, Keller, & Davis, 2012), and careful consideration of the ethical implications of the study is required.
As a result, the following PICOT question is going to be explored: in gerontologic patients (P), what is the effect of a community-based intervention (I) on the occurrence of suicides (O) compared with conventional interventions (C) within the early stages of terminal illnesses (T)?
The proposed intervention is a comprehensive community-based program that should incorporate multiple non-pharmacological activities, including exercises, games, and discussions; also, it will involve counseling. A preliminary investigation shows that there is some evidence to the mentioned interventions being helpful for the resolution of the problem and the improvement of the quality of life of the population (Coburn et al., 2012; Moyle, Parker, & Bramble, 2014; Sun, 2016). Therefore, their use in the proposed study is justified.
The suggested type of research is the experimental one because the exposure of the participants to the treatment can be randomized and controlled, which enables the use of a randomized controlled trial (RCT) in the project (Burns, Grove, & Gray, 2015). The lack of exposure to the intervention does not presuppose the lack of treatment (the patients from the control group will be treated as usual), and the presence of exposure should not carry risks (due to the program being evidence-based). Therefore, no major ethical issues rule out an RCT.
PICOT: In gerontologic patients (P), what is the effect of a community-based intervention (I) on the occurrence of suicides (O) compared with conventional interventions (C) within the early stages of terminal illnesses (T)?
The mentioned PICOT question implies that the proposed study is to test the intervention with the help of a control group, which indicates that it can be carried out as a quasi-experiment or an experiment. According to Burns et al. (2015), both approaches can help to determine the effects that treatments can have. The former type of research is easier to conduct, but the latter one is more controlled and produces more reliable results, which makes it particularly attractive. Burns et al. (2015) state that an experiment requires the randomization and control of the exposure to treatment, which is achievable in the proposed study. Thus, it is suggested to carry out a randomized controlled trial with rigorous control of the process to employ a more powerful and accurate research method.
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A theoretical framework that can be proposed for the project is the Johns Hopkins Nursing Evidence-Based Practice model (The Johns Hopkins University, The Johns Hopkins Hospital, & Johns Hopkins Health System, n.d.). It contains a simple but detailed and comprehensive set of guidelines and tools that facilitate the process of the translation of evidence-based approaches into practice, which is necessary for my project because it requires the implementation of an evidence-based intervention. Thus, the three-step framework is appropriate for the proposed research, and the permission to use its tools for the project can be solicited from the Johns Hopkins University.
Burns, N., Grove, S., & Gray, J. (2015). Understanding nursing research (6th ed.). Amsterdam, Netherlands: Elsevier. Web.
Coburn, K. D., Marcantonio, S., Lazansky, R., Keller, M., & Davis, N. (2012). Effect of a community-based nursing intervention on mortality in chronically ill older adults: A randomized controlled trial. PLoS Medicine, 9(7), 2-17. Web.
Conwell, Y. (2014). Suicide later in life. American Journal of Preventive Medicine, 47(3), S244-S250. Web.
Moyle, W., Parker, D., & Bramble, M. (2014). Care of older adults: A strengths-based approach. Port Melbourne, Australia: Cambridge University Press. Web.
Sun, H. J. (2016). Suicide prevention efforts for the elderly in Korea. Perspectives in Public Health, 136(5), 269-270. Web.
The Johns Hopkins University, The Johns Hopkins Hospital, & Johns Hopkins Health System. (n.d.). Johns Hopkins Nursing Evidence-Based Practice model. Web.