In healthcare, practice change is a common phenomenon because medicine changes quickly, and so do social trends and tendencies. Healthcare strategies aimed at the resolution of various public health problems usually target large population groups and communities known for the inhomogeneity of their demographics. As a result, implementing a change of practice, it is critical to collect a wide range of available data in order to support the new practice with evidence and ensure its efficiency.
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PICOT Question and Identified Problem
The PICOT question used for this project revolves around individuals affected by obesity aged between 40 and 60 and the effectiveness of physical exercise programs in which they enroll. The issue under discussion is the decreased efficiency of physical exercise programs for the aforementioned groups due to various socio-cultural and ecological factors. Potentially, regular physical exercise is a good and effective way that could stimulate the loss of excess weight and improve the overall quality of life of people suffering from obesity. However, the implementation of such programs is often complicated and slowed down by the lack of motivation, readiness to commit, and emotional unpreparedness among patients. As a result, the expected positive outcomes of such programs are never achieved to a full extent.
Links between the PICOT Statement, Research Articles, and the Identified Nursing Practice Problem
Two research studies focusing on the problem of the effectiveness of exercise programs for obese populations were reviewed for this project. In both of these articles, the authors found that the major problem interfering with efficiency was the lack of adherence. Verreijen et al. (2017) specified that the rate of the participants dropping out of their research project was very high. In turn, this tendency led to uneven results in the compared groups. Mama et al. (2015) noted that in their study that involved female participants of African American and Hispanic backgrounds the effectiveness of exercise programs was limited by the lack of commitment among subjects. As a result, it is possible to conclude that the rates of adherence to exercise programs among adult populations affected by obesity are the nursing practice problem that requires solutions.
Proposed Evidence-Based Practice Change
In their research, Lambert et al. (2017) found a creative solution for the problem of adherence to exercise among adult patients. The participant groups targeted by this study included individuals affected by musculoskeletal conditions. However, the research project was focused specifically on the rates of effectiveness of an exercise program administered and maintained in two different manners in the compared groups. To be more precise, the authors compared an exercise program powered by an app that was supported remotely by nurses on a regular basis with a program whose description was distributed using paper handouts (Lambert et al., 2017). The former manner of program maintenance was more effective and achieved higher rates of adherence. Consequently, the proposed practice change will include a more focused interaction with the participants of exercise programs, weekly reach-outs for better motivation, and educational sessions about the importance of exercise delivered to families and communities in order to stimulate group participation and prevent the isolation of separate participants.
The proposed practice change is powered by a substantial body of evidence that signifies that the participants of exercise programs fail to adhere when they are not encouraged by nursing staff and other professionals and when they lack the support of family members and communities. As a result, in order to change this flawed tendency, it is possible to propose a nurse-led and supervised approach to exercise. This strategy would provide the participants with the emotional support they require and inspire them to continue training.
Lambert, T., Harvey, L., Avdalis, C., Chen, L., Jeyalingam, S., Pratt, C.,… Lucas, B. (2017). An app with remote support achieves better adherence to home exercise programs than paper handouts in people with musculoskeletal conditions: A randomized trial. Journal of Physiotherapy, 63, 161–167.
Mama, S. K., McCurdy, S. A., Evans, A. E., Thompson, D. I., Diamond, P. M., & Lee, R. E. (2015). Using community insight to understand physical activity adoption in overweight and obese African American and Hispanic women: A qualitative study. Health Education & Behavior, 42(3), 321-328.
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Verreijen, A. M., Engberink, M. F., Memelink, R. G., Plas, S. E., Visser, M., & Weijs, P. J. (2017). Effect of a high protein diet and/or resistance exercise on the preservation of fat free mass during weight loss in overweight and obese older adults: A randomized controlled trial. Nutrition Journal, 16(1), 2-8.