PICO-T Formatted Question
Read the assigned Week 1 Case Study for Threaded Discussion and formulate one searchable, clinical question in the PICO-T format. There are several potential questions that could be asked. Identify if the focus of your question is assessment, etiology, treatment, or prognosis. Remember to integrate APA references (References should not be older than 10 years of age, and should not be from India, and should provide a hyperlink to where professor may be able to view article if necessary).
Week 1 Case Study for Threaded Discussion
Mary is a 65-year-old woman with a 3-year history of diabetes is seen in the hospital for worsening dyspnea and cough. She has had chronic obstructive pulmonary disease (COPD) since age 55. She now has dyspnea with walking one-third of a block and a persistent cough. Her type 2 diabetes has been managed with diet and exercise.
She was treated via a three-day stay in the hospital and sent home with a drug regime and since then has been seen in the ER two times and now re-hospitalized with shortness of breath and blood sugar of 245.
She does not understand why the medications are not working. She needs to be healthy because she is the only caregiver for her ailing bed-ridden husband with ALS.
Mary is the only caregiver and takes all of her medication but eats on the run when not caring for her husband. She now does not exercise and only goes out of the home for doctor visits and grocery shopping. She is always tired and is extremely worried about her husband’s health issue.
They are on a fixed income since retirement. During the hospital stay she was put on new medications and one of them was Prednisone. The doctor has told her to change her lifestyle, continue with meds and to monitor her vital signs at home. He has also suggested a move to an assisted living center.
She has many questions about assisted living. She is willing to do anything but has no one to help her make this decision. They have no family or close friends near them.
The nurse just came in and told her she is discharged, handed her a bunch of papers about diet, exercise, and diabetes and said a home health nurse would come to the house in a few days.
Formulate searchable, clinical questions in the PICO-T Model format using the material in this case study.
There are several potential questions that could be asked, but you only need to identify one. Determine if the focus of each question is assessment, etiology, treatment, or prognosis.
Explanation of PICO-T Model:
The PICO-(T) format is a way to develop a clinical question that lends itself to searching for evidence. PICO-(T) is an acronym for
P = population of interest
I = intervention of interest
C = comparison of interest
O = outcome of interest
T = time
All of the PICO-(T) elements may not be present in every clinical question. For example, the T (time) may not be relevant or there may be no C (comparison of interest).
In quantitative research that has an experimental design, you will find interventions (I), and perhaps comparisons, (C) that are independent variables. The outcomes (O) are dependent variables.
PICO-T is a model and as mentioned in the lesson, not every part of the PICO-T fits with every question. Some questions do not have a comparison group, some questions do not have an intervention. Some questions are not looking at an issue over time so the time will not apply.
1. P= Population you are asking the question about. This is almost always a group of patients rather than one person. There are case studies that examine one person–you may have experienced rounds where a number of disciplines gather and discuss one patient, but generally PICO-T questions are looking at a group.
2. I= Intervention. Here you will be applying an intervention to help with a patient condition. The interventions are nursing care/education related. Interventions that involve medication are typically medication clinical trials and these are most often run by physicians. Our focus is more on nursing care. Some questions will not involve an intervention if asking a descriptive question such as a predictive (risk factor) question or a correlational (relational) question.
3. C= Comparison Group. Here you compare the population to a group of patients that typically have “standard care” instead of the intervention. There are ethical issues here where patients must at least be provided care that would be given normally. Not all questions involve a comparison group.
4. O= Outcome. Here you are generally looking for a positive outcome. This is an improvement in the patient condition as a result of the intervention (of course it does not always work this way). If your question is descriptive, then you will be looking at what is happening and not at a change from an intervention. If risk factors are involved as in a predictive question, then the outcome can be negative such as certain lifestyle behaviors leading to disease.
5. T= Time again involves looking at the effects of an intervention over time. Generally nursing studies will take place over a reasonable amount of time due to time and resource considerations. I find that 6 months or a year often works. This could also apply to predictive questions where risk factors are followed over time to see if the negative outcomes appear. (i.e., high cholesterol leading to heart disease).
Reference (Chapter 4: Finding Problems and Writing Questions, pp. 77-100)
Houser, Janet. (2015). Nursing research: Reading, using, and creating evidence (3rd ed.). Sudbury, MA: Jones and Bartlett. [VitalSource Bookshelf Online]. Retrieved from https://bookshelf.vitalsource.com/#/books/9781284055702/
Janet Houser (2015, p. 93) in the book titled “Nursing research: Reading, using, and creating evidence” states the following regarding the acronym PICO:
“Two guides are helpful in developing a good research question. One of them is described by the acronym PICO, which outlines the elements of a good quantitative question. PICO stands for population, intervention, comparison, and outcome. Using preoperative education for short-stay patients undergoing prostatectomy as an example, a research question based on PICO might look like this:
• Population: In radical prostatectomy patients staying in the hospital one day after surgery …
• Intervention: Does customized preoperative teaching …
• Comparison: Compared to standard preoperative teaching …
• Outcomes: Lead to better pain control as measured by a visual analog scale?”