Chronic Diseases: Evidence-Based Project

Chronic diseases become one of the most threatening health issues all over the globe. In particular, insufficient health literacy unreasonably impacts older adults in the United States. The challenge is complicated by the fact that the aging population, being a vulnerable group, needs adequate patient-oriented education. At this point, nurses are expected to engage the patients in highly-productive communication, explaining all the necessary points to improve their health outcomes and behaviors (Hessle, 2014). The current lack of various teaching strategies as well as the inability to properly promote health literacy in older adults causes the deterioration of their health statuses. Considering the topic of the proposed research, it is possible to come up with the following PICOT question:

  • (P) – In elderly patients with chronic diseases
  • (I) – Does patient education intervention
  • (C) – Compare with only medication treatments
  • (O) – Increase their health knowledge and improve their health statuses
  • (T) – In a period of 6 months?

As a result of the mentioned teaching intervention, it is expected that the health literacy of older adults would be significantly increased, thus leading to their improved health outcomes. In particular, patients with chronic diseases would be aware of their health peculiarities and ways to either facilitate or reduce their manifestations (Garcia, Espinoza, Lichtenstein, & Hazuda, 2013). The importance of the issue in the context of poor outcomes or costs cannot be overestimated. In case the desired outcomes would not be achieved, the situation is likely to develop in an adverse way. Therefore, the key approach to accomplish the proposed goal is to be associated with age-related education and communication strategies (Souza et al., 2014). More importantly, these strategies are to be clearly planned and adapted to the individual needs and concerns of a certain patient.

The search of the literature for evidence was conducted according to the guidelines of evidence-based research. Such databases as ProQuest Nursing & Allied Health Source, PubMed, Medline, CINAHL, and so on were searched. In order to ensure the appropriateness of search, the literature that was published less than five years old was selected. The table presented below outlines the key appraisal points. The article by Garcia et al. (2013) named “Health literacy associations between Hispanic elderly patients and their caregivers” refers to the first study while “Functional health literacy and glycaemic control in older adults with type 2 diabetes: a cross-sectional study” by Souza et al. (2014) is the second one.

Rapid Critical Appraisal Evidence-Based Clinical Practice Guidelines Numbered Studies
Unless otherwise specified, answers are Y=yes; N=no; U-unknown 1 2
1. Are the results of the study valid
1. Who were the guideline developers? Fill in  Garcia, Espinoza, Lichtenstein, and Hazuda; Souza, Apolinario, Magaldi, Busse, Campora, and Jacob-Filho.
2. Were the developers representative of key stakeholders in this specialty (interdisciplinary?) Y Y
3. Who funded the guideline development? Fill in  Taylor & Francis; BMJ Publishing Group Limited.
4. Were any of the developers of the guidelines funded researchers of the reviewed studies? U U
5. Did the team have a valid development strategy? Y Y
6. Was an explicit (how decisions were made), sensible and imperial process used to identify, select, and combine evidence? Y Y
7. Did its developers carry out a comprehensive,
reproducible literature review within the past 12 months of its publication/revision?
8. Were all important options and outcomes considered? Y Y
9. Is each recommendation in the guideline tagged by the level/strength of evidence upon which it is based and linked with the scientific evidence? Y Y
10. Do the guidelines make explicit recommendations (reflecting value judgments about outcomes)? Y Y
11. Has the guideline been subjected to peer review and testing? Y Y
2. Applicability/Generalizability
12. Is the intent of use provided (e.g. national, regional, local)? Y Y
13. Are the recommendations clinically relevant? Y Y
14. Will the recommendations help me in caring for my patients? Y Y
15. Are the recommendations practical/feasible (e.g. resources-people and equipment- available)? Y Y
16. Are the recommendations a major variation from current practice? N Y
17. Can the outcomes be measured through standard care? Y Y

Table 1. Evaluation Table.

PICOT question organizer

P Population In elderly patients with chronic diseases
I Intervention or
Issue of interest
Does patient education intervention
C Comparison Compare with only medication treatments
O Outcome Increase their health knowledge and improve their health statuses
T Time frame In a period of 6 months?

Search Tracker

Search # Initial search terms Database And/Or? Added search terms Title (Ti)
Anywhere, etc.
# of articles found
1 Health literacy
Elder patients
ProQuest Nursing & Allied Health Source, PubMed, Medline, CINAHL Or
Time frame Anywhere 7(3)
2 Teaching intervention
Elder patients
ProQuest Nursing & Allied Health Source, PubMed, Medline, CINAHL And Time frame Anywhere 10(5)
3 Reduce chronic disease outcomes
Elder patients with chronic diseases
ProQuest Nursing & Allied Health Source, PubMed, Medline, CINAHL Or
Time frame Anywhere 12(3)
4 Elder patient education ProQuest Nursing & Allied Health Source, PubMed, Medline, CINAHL And Time frame Anywhere 15(6)
5 Nursing intervention
Older adults with chronic diseases
ProQuest Nursing & Allied Health Source, PubMed, Medline, CINAHL Or
Time frame Anywhere 9(3)

Table 2. Search Tracker.


Garcia, C. H., Espinoza, S. E., Lichtenstein, M., & Hazuda, H. P. (2013). Health literacy associations between Hispanic elderly patients and their caregivers. Journal of Health Communication, 18(1), 256-272.

Hessle, S. (2014). Human rights and social equality: Challenges for social work. Farnham, Surrey: Ashgate Publishing Limited.

Souza, J. G., Apolinario, D., Magaldi, R. M., Busse, A. L., Campora, F., & Jacob-Filho, W. (2014). Functional health literacy and glycaemic control in older adults with type 2 diabetes: a cross-sectional study. BMJ Open, 4(2), 1-8.

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