1.1 PICO Question PDF

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Assignment 1.1 PICO Question...

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Assignment 1.1: PICO Question Laurel Kepner

Department of Nursing, Maryville University

NURS 601: Evidence Based Practice in Nursing

Professor Sara Davenport

March 14, 2021

Introduction The purpose of this brief paper will be to address a research concern by proposing a question in a PICO format. A PICO question is a way to address a research concern, identifying (P) as the population the question addresses, (I) as the intervention that will be tested against (C) the comparison, and (O) as the outcome the question anticipates. The PICO question this brief paper will address is the following: “In mental health patients, does the use of motivational interviewing techniques versus not using motivational interviewing techniques improve compliance to adherence of medication and treatment plans?” In this case, the population the research is concerned with (P) is mental health patients, the intervention (I) is the use of motivational interviewing techniques, the comparison (C) is not using motivational interviewing techniques, and the proposed outcome (O) is improved compliance of these patients to their medication and treatment plans. Background Non-adherence with medication and treatment plans are common interferences to the effective treatment for many psychiatric disorders. Clients who present with illnesses such as bipolar disorder, schizophrenia, and other mental health disorders commonly display challenging behavior, such as non-compliance to medication or substance abuse, which have a harmful impact on the illness’s progression, including frequent readmissions (Chiappetta et. al., 2018). Active psychotic indicators, undesirable symptoms, and mental instabilities can cause making modifications to such problematic behavior very challenging with mental health clients. However, there is restricted information regarding how to improve compliance with medication and treatment routines for this patient population (Zygmunt et.

al., 2002). The purpose of this paper will be to determine if the use of motivational interviewing techniques can lead to improved compliance with psychiatric patients with their medication and treatment regimens. Motivational interviewing (MI) is a psychotherapy method developed by clinical psychologists Stephen Rollnick and William R. Miller. It is a directive, patient-centered therapy technique implemented to stimulate behavioral transformation by assisting patients to investigate and sort out their feelings of uncertainty and indecisiveness (Serobatse et. al., 2014). This style of psychotherapy is more goal-oriented and purposeful than traditional Rogerian patient-oriented psychotherapy. Physicians and therapists use this method in order to motivate patients to make necessary changes in their behavioral patterns (Barkhof et. al., 2006). Conclusion Compliance is a concept that impacts the field of nursing in numerous ways. Patient’s compliance with their medication and treatment regimens influences patient safety and the effectiveness of treatments. How patients comply with their treatment plans impacts how effective health care providers can be with their interventions and can significantly influence patient outcomes in either positive or negative ways. Interventions such as the technique of therapeutic motivational interviewing (MI) have been demonstrated to improve compliance with various treatment procedures (Chiappetta et. al., 2018). However, further research is needed to determine if motivational interviewing techniques can positively impact mental health patients' compliance towards their medication regimes and treatment plans.

References:

Barkhof, E., Hann, L. D., Meijer, C. J., Fouwels, A. J., Keet, I. P. M., Hulstijn, K., Schippenzrs, G. M. & Linszen, D. H. (2006). Motivational interviewing in psychotic disorders. Current Psychiatry Reviews, 2(2), 207213. https://doi.org/10.2174/157340006776875932 Chiappetta, L., Stark, S., Mahmoud, K. F., Bahnsen, K. R. & Mitchell, A. M. (2018). Motivational interviewing to increase outpatient attendance for adolescent psychiatric patients. Journal of Psychosocial Nursing, 56(6), 31-35. http://doi.org/10.3928/02793695-20180212-04

Abstract Motivational interviewing (MI) is a therapeutic technique that has been demonstrated to increase adherence to various treatment regimens. Nonattendance at outpatient appointments is associated with read-mission to psychiatric hospitals. The purpose of the current study was to examine the effectiveness of MI in

promoting treatment adherence and increasing pediatric attendance rates at patients' first follow-up appointment after inpatient admission. A sample of 111 patients discharged from one of two child and adolescent units at an urban, inpatient psychiatric hospital in Southwestern Pennsylvania participated in the MI discharge process. Compared to hospital population data from 1 month prior to the current study, the MI discharge process demonstrated an increase of approximately 10% in attendance at the scheduled follow-up appointments and a decrease of approximately 4% in cancellations and no-show appointments. It was

concluded that particularly for adolescents, MI may be a valuable treatment approach grounded in partnerships with health care providers, patients, and families to enhance outpatient appointment attendance. [Journal of Psychosocial Nursing and Mental Health Services, 56(6), 31–35.]

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare (4th Edition): A guide to best practice. Walters Kluwer.

Serobatse, M.B., Du Plessis, E. & Koen, M.P. (2014). Interventions to promote psychiatric patients’ compliance to mental health treatment: A systematic review. Health SA Gesondheid, 19(1), 799-808. http://doi.org/10.4102/hsag.v19i1

Zygmunt, A., Olfson, M., Boyer, C. A. & Mechanic, D. (2002). Interventions to improve medication adherence in schizophrenia. American Journal of Psychiatry, 159(10), 1653–1664. https://doi.org/10.1176/appi.ajp.159.10.1653...