Introduction
The growing prevalence of type 2 diabetes makes it safe to say that additional research has to be conducted in order to establish a stronger foundation of evidence for the progression of diabetes in minority populations. The current paper reviews the existing literature and creates room for the implementation of an evidence-based method that features counseling and exercise as the key elements of preventing the progression of type 2 diabetes in Hispanic patients. The nurse practice issue was studied in detail, and the author analyzed the connection between the chosen articles and their proposal of how nurse specialists could cope with the progression of diabetes in minority populations, such as Hispanics.
PICOT: Will an all-inclusive educational program including face-to-face counseling on diet and workout for Hispanic patients with type 2 diabetes lead to a progressive lifestyle change and reduce the advancement of their adverse health condition within 6 (six) months since the deployment of the counseling-based intervention?
Background
The first article reviewed by the author was written by Hawkins, Watkins, Bonner, and Thompson (2016), who touched upon the issue of race-based predictors of diabetes and the association of the latter with consequent depression diagnoses. The significance of the article may be outlined as a thorough focus on minority populations. The purpose of Hawkins et al.’s (2016) article was to point out the existing trends in diabetes progression in minority populations. The objectives, on the other hand, were to establish an improved body of knowledge on type 2 diabetes and the benefits of mental health care for patients with diabetes. The research question investigated by Hawkins et al. (2016) was whether race or ethnicity affect the process of mental care provision and diabetes outcomes.
The second article was written by Oh and Ell (2016), who defined the problem of their investigation as the growing influence of depressive states and behaviors on type 2 diabetes outcomes in patients from minority populations. This article may be considered significant because it provides a detailed outlook on depression remissions and the ideas inherent in problem-solving therapy. The purpose of Oh and Ell’s (2016) article was to test if self-care behaviors would improve the outcomes in patients with diabetes. The key objectives stated by the researchers were to find essential benefits related to therapy and create a link between depression and diabetes. According to Oh and Ell (2016), it would significantly facilitate the process of treating diabetes, as minority populations would take care of their mental health and overcome the psychological barriers that averted them from receiving high-quality services in the past. The research question investigated in Oh and Ell’s (2016) article was whether improved patient self-care could be achieved with the help of problem-solving therapy and depression remission.
Link to the Nurse Practice Issue
As for the nurse practice issue, it should be noted that both studies reviewed above touched upon the Hispanic population and its association with an increased risk of being exposed to type 2 diabetes. Hawkins et al. (2016), for example, took on the preconception that Hispanics are most threatened by diabetes and disproved it while also pointing out several iterations of discrimination that minority patients could face when admitted to the hospital. It was an evidence-based decision and not a mere assumption, as the authors conducted an in-depth literature review on the subject. Oh and Ell’s (2016) article also perfectly relates to the chosen nurse practice issue due to the evidence regarding a strong association between mental health issues and diabetes. From the perspective of coping with type 2 diabetes in the Hispanic population, nurses have to focus on patient expectations and never underestimate the inherent association between depression and diabetes. Hawkins et al. (2016) and Oh and Ell (2016) accurately represent the minority populations and suggest that the standards regarding diabetes care across the United States have to be improved with the help of interventions relating to mental health as well.
PICOT Discussion
In order to answer the PICOT question presented above, the author is going to amalgamate Hawkins et al.’s (2016) and Oh and Ell’s (2016) findings to see how mental health care could eventually support initiatives aimed at type 2 diabetes in the Hispanic population. The interventions proposed within the framework of those two articles are perfectly in line with the existing PICOT, as they revolve around the increasingly important role of mental health across interventions that previously only featured medication and exercise. Therefore, the need to investigate the benefits of counseling and physical exercise in Hispanic patients with type 2 diabetes is validated with the help of articles written by Hawkins et al. (2016) and Oh and Ell (2016).
Method of Study
There is no vital difference between methods proposed by Hawkins et al. (2016) and Oh and Ell (2016) because both articles feature a qualitative design based on surveys. The ability to obtain valid information within a relatively short period is what makes survey-based research projects stand out, as the key advantage is the possibility to address a larger population without losing data validity. As for the essential limitations of the study, the one that could be regarded as essential is that Hispanic patients are already a minority population, so they could resort to subjective answers that would reduce the effectiveness of the proposed approach and generate inaccurate data overall. Randomized clinical trials that were utilized by Hawkins et al. (2016) and Oh and Ell (2016) to collect all the necessary information allowed them to overcome the previous limitations but might have affected the validity of the data obtained via surveys.
Results of Study
The results of the studies completed by Hawkins et al. (2016) and Oh and Ell (2016) show that patients with diabetes are relatively reluctant to receiving expert psychological advice from counselors due to the lack of understanding of what are the key reasons for mental health interventions in patients with diabetes. They found that such individuals are much more predisposed to the development of depressive states, as the impact of the minority population status averts Hispanic patients from making appointments with doctors (Hawkins et al., 2016; Oh & Ell, 2016). It was also pointed out by the researchers that self-care behaviors are also hard to find in Hispanic patients, as they are rarely motivated by positive health outcomes and do not believe in successful depression remission. The core implication for both articles is identical: self-care behaviors are in no way associated with motivation and have to be elicited differently if care providers expect to provide comprehensive care and protect the mental and physical health of Hispanic patients with type 2 diabetes.
Ethical Considerations
The first important ethical consideration associated with the given studies is that the researchers ensured to receive informed consent from every study participant. It allowed them to remain certain throughout their projects that every respondent is interested in providing relevant, truthful answers to all the questions. The second important ethical consideration was the researchers protecting the privacy of respondents and keeping their feedback confidential. Despite the target audience being addressed in an appropriate manner, it should still be noted that both articles might become even more beneficial if the researchers eventually found a way to promote their findings among the members of the Hispanic population with type 2 diabetes.
Proposed Evidence-Based Practice Change
Based on the evidence that was reviewed within the framework of the current project, the author proposes to implement counseling meetings paired with physical exercise sessions for Hispanic patients with type 2 diabetes. The rationale for the proposal is the lack of emotional support that minority populations tend to receive throughout the treatment process (Oh & Ell, 2016). With the help of in-person counseling, nurses would be able to gain ultimate insights into patient beliefs and needs without having to conduct longitudinal studies and assessing quantitative data at the end of the day. The participation of patients in the proposed intervention is essential, as their opinions might affect the existing practices aimed at reducing the risks associated with type 2 diabetes in the Hispanic population (Hawkins et al., 2016). Therefore, nurses would be required to switch back and forth between the physical and mental health of their patients with type 2 diabetes in order to find the perfect balance between emotional support and reward-based motivation inherent in physical exercises.
Outcomes Comparison
The anticipated outcomes for the PICOT question proposed within the framework of the current paper are an improved level of collaboration between patients and providers and enhanced access to emotional support among Hispanic patients with type 2 diabetes. The author believes that the current evidence-based intervention would have a positive effect on local minority populations due to the extended number of opportunities for patients to provide their feedback and directly participate in the care process. This would also affect care providers to a certain extent, as they would gain insight into patient-centered practices and ensure that their strategies do not interfere with patient needs and aspirations, especially given that the focus group for the proposal is a minority population. Despite the articles picked for the current project being majorly qualitative, the outcomes of the current PICOT proposal should be expected to be statistically significant. Similarly to Hawkins et al. (2016) and Oh and Ell (2016), the author expects to validate the correlation between diabetes and mental health so as to provide accentuated care to representatives of the Hispanic population with type 2 diabetes.
Conclusion
Overall, the current project can be outlined as a thorough literature review that smoothly transitions into an evidence-based practice change proposal. The lack of knowledge on the subject of how mental health care could affect patients with type 2 diabetes leaves enough room for an extended discussion on the subject of how in-person counseling and exercise could protect Hispanic patients from worsening health conditions. It should be noted that there is only a limited number of articles dwelling on the benefits of mental health care during the treatment of type 2 diabetes, so the current proposal should unlock new viewpoints on the subject and contribute to the current pool of evidence on the association between mental health and diabetes. The prevalence of depressive states in diabetes patients is not a rare occurrence (this is true especially for minority populations), so it should be crucial to ensure that there is a perfect balance between the newly proposed treatment methods and their conventional alternatives.
References
Hawkins, J., Watkins, D. C., Bonner, T., & Thompson, T. L. (2016). Racial/ethnic differences in predictors of mental health treatment in persons with comorbid diabetes and depression. Social Work in Public Health, 31(6), 511–519. Web.
Oh, H., & Ell, K. (2016). Depression remission, receipt of problem-solving therapy, and self-care behavior frequency among low-income, predominantly Hispanic diabetes patients. General Hospital Psychiatry, 41(2), 38–44. Web.