The diagnosis selected for this assignment is histamine intolerance, also referred to as histaminosis. Histaminosis occurs when histamine, an organic compound that is involved in immune responses taking place in particular tissues or organs, starts to accumulate in the body. The mechanisms leading to the development of histaminosis differ from those causing allergic diseases, but the symptoms of the two conditions are quite similar. This paper discusses the practice problem with reference to the John Hopkins Nursing EBP Model and the credibility of sources.
The issue can benefit from scholarly research and the use of an evidence-based approach. It is because there is an ongoing discussion concerning the best diet to be followed by patients with histamine intolerance to prevent unwanted symptoms, such as hypertension, digestive problems, ENT and gynecological disorders, etc. Additionally, the problem is that there is a huge list of products that are supposed to be potentially harmful to patients with histamine intolerance. Keeping to a diet that would exclude all of them can be challenging since histaminosis patients may also have comorbid conditions that impose dietary restrictions. Taking that into account, evaluating scientific literature that reviews and tests therapeutic strategies other than diets can be of utmost importance.
Any journal articles and websites should contain credible and properly tested recommendations to be used to inform decision-making. To determine the credibility of such types of sources, practitioners are expected to evaluate them using a set of criteria. The first criterion that may be proposed is the degree of the source’s relevance to the situation being analyzed. For instance, sources studying people with some atypical histamine intolerance symptoms or other conditions in addition to histaminosis can be impractical in the given situation. Another criterion refers to whether the information is recent and up-to-date. In nursing and medical research, information becomes outdated very fast, and it should be taken into account (Umesh, Karippacheril, & Magazine, 2016). Significantly, the most recent studies do not exist in a vacuum – they build up and comment on what has been reported about the problem, thus adding credibility to some findings and bringing other findings into question.
Next, to evaluate journal articles, one can pay attention to the type of study with reference to the hierarchy of evidence and give preference to generalizable and conceptual studies. Modern researchers focusing on quality assessments also recommend paying attention to the sample size and whether it is sufficient to detect meaningful effects and differences between population subgroups (Umesh et al., 2016). Additionally, it goes without saying that practitioners should rely on information from peer-reviewed journals (Umesh et al., 2016). Peer-reviewed sources are evaluated by experts in the field with attention to multiple criteria, such as evidence quality and methodological soundness, which is why choosing them is always beneficial.
The evaluation criteria to be applied when assessing the credibility of websites are quite similar to the criteria for journal articles. To begin with, whether online information is peer-reviewed requires consideration (it can be evaluated by experts/scientific editors or come from peer-reviewed journal articles) (Sbaffi & Rowley, 2017). Additionally, information on credible websites is updated on a regular basis (Sbaffi & Rowley, 2017). Basically, to evaluate a website, it might be practical to establish whether it cites the results of scientific studies and assess the quality of such studies relying on the abovementioned criteria for journal articles.
For the purpose of this assignment, a literature search was conducted with the help of the tools identified in the previous assessment, such as NCBI and PubMed. One of the basic problems limiting the availability of credible evidence is that not many level one and two studies have been conducted within the last five years. However, a few peer-reviewed sources from reputable journals that nurse practitioners may regard as helpful have been found. For instance, the work by Reese et al. (2017) is an article from a peer-reviewed and reputable journal referenced in NCBI databases. The source basically reviews the state of histaminosis management research by summarizing and comparing the results of more than thirty studies published from 1986 to 2014 (Reese et al., 2017). Based on the reviewed sources, the study proposes a simple approach to patient management in suspected histaminosis, which makes it helpful and practice-oriented.
Additionally, the conducted literature search revealed the presence of credible studies that propose innovative strategies and contribute to the development of a solid knowledge base. The article by Comas-Basté, Latorre-Moratalla, Bernacchia, Veciana-Nogués, and Vidal-Carou (2017) is a recent peer-reviewed research study that establishes the effectiveness of a new method of urine analysis to diagnose histaminosis. Another source that contains credible information is the article by Chung et al. (2017) that reports the results of a recent peer-reviewed laboratory study devoted to cooking methods’ impact on alimentary products’ histamine content. Its results can be used to inform patient nutritional education in the cases of histamine intolerance.
Finally, patient safety remains one of the key priorities for qualified and responsible nursing and medical professionals. The John Hopkins EBP Model, which can be used to improve histaminosis care, offers a simple but effective approach to making care decisions. The model emphasizes three critical steps, such as formulating a practice question (for instance, best practices in histaminosis patient education), evidence collection/analysis, and translating evidence into practice. The incorporation of credible evidence into the model is of utmost importance. It is because the use of low-quality evidence can result in ineffective care, such as unnecessary diagnostic tests or dietary restrictions that affect patients’ quality of life without relieving any symptoms. The model could help to improve histaminosis care by guiding practice changes and pilot studies related to patient nutritional counselling, lifestyle recommendations, and diagnostic tests.
References
Chung, B. Y., Park, S. Y., Byun, Y. S., Son, J. H., Choi, Y. W., Cho, Y. S.,… Park, C. W. (2017). Effect of different cooking methods on histamine levels in selected foods. Annals of Dermatology, 29(6), 706-714.
Comas-Basté, O., Latorre-Moratalla, M. L., Bernacchia, R., Veciana-Nogués, M. T., & Vidal-Carou, M. C. (2017). New approach for the diagnosis of histamine intolerance based on the determination of histamine and methylhistamine in urine. Journal of Pharmaceutical and Biomedical Analysis, 145, 379-385.
Reese, I., Ballmer-Weber, B., Beyer, K., Fuchs, T., Kleine-Tebbe, J., Klimek, L.,… Werfel, T. (2017). German guideline for the management of adverse reactions to ingested histamine. Allergo Journal International, 26(2), 72-79.
Sbaffi, L., & Rowley, J. (2017). Trust and credibility in web-based health information: A review and agenda for future research. Journal of Medical Internet Research, 19(6), 1-17.
Umesh, G., Karippacheril, J. G., & Magazine, R. (2016). Critical appraisal of published literature. Indian Journal of Anaesthesia, 60(9), 670–673.