Case Study for Threaded Discussion
Read the assigned case study 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 references.PICO(T) FORMAT LISTED ON THIS PAGE
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) format using the material is this case study.
There are several potential questions that could be asked, but you only need to identify two. Determine if the focus of each question is assessment, etiology, treatment, or prognosis.
As you consider the who, what, where, when, why, and how of the situation, you begin to formulate a clinical question that addresses these queries.
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. Variables will be discussed in more detail later in the course.
Once you have formulated your clinical question and determined the PICO(T) elements, the next step is to identify key terms that reflect the elements. The key terms are the actual words or phrases that you will use to search the indices, databases, and search engines. The goal is to select key terms that will likely match those terms that the authors assigned to relevant research reports.
The following diagram illustrates how the search for evidence mirrors the research process. Notice that the place where both processes connect is at the key terms.