Assignment: NUR 550 Benchmark -Evidence-Based Practice Project: Literature Review 

Assignment: NUR 550 Benchmark -Evidence-Based Practice Project: Literature Review 

Benchmark -Evidence-Based Practice Project: Literature Review
The purpose of this assignment is to write a review of the research articles you evaluated in your Topic 5 “Evidence-Based Practice Project: Evaluation of Literature” assignment. If you have been directed by your instructor to select different articles in order to meet the requirements for a literature review or to better support your evidence-based practice project proposal, complete this step prior to writing your review.

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A literature review provides a concise comparison of the literature for the reader and explains how the research demonstrates support for your PICOT. You will use the literature review in this assignment in NUR-590, during which you will write a final paper detailing your evidence-based practice project proposal.
In a paper of 1,250-1,500, select eight of the ten articles you evaluated that demonstrate clear support for your evidence-based practice and complete the following for each article:
1. Introduction – Describe the clinical issue or problem you are addressing. Present your PICOT statement.
2. Search methods – Describe your search strategy and the criteria that you used in choosing and searching for your articles.
3. Synthesis of the literature – For each article, write a paragraph discussing the main components (subjects, methods, key findings) and provide rationale for how the article supports your PICOT.
4. Comparison of articles – Compare the articles (similarities and differences, themes, methods, conclusions, limitations, controversies).
5. Suggestions for future research: Based on your analysis of the literature, discuss identified gaps and which areas require further research.
6. Conclusion – Provide a summary statement of what you found in the literature.
7. Complete the “APA Writing Checklist” to ensure that your paper adheres to APA style and formatting criteria and general guidelines for academic writing. Include the completed checklist as an appendix at the end of your paper.
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.
You are required to cite eight peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
RUBRIC
Criteria Description
Introduction
5. Excellent
The clinical issue or problem and PICOT statement are thoroughly described.

Search Methods
5. Excellent
The search strategy and criteria used in choosing and searching for articles is thoroughly described.

Synthesis of Literature
5. Excellent
A well-developed paragraph for each article is presented. The main components (subjects, methods, key findings) are thoroughly discussed, and substantial rationale for how each article supports the PICOT is clearly provided.

Criteria Description
Comparison of Articles
5. Excellent
A detailed comparison of the similarities, differences, themes, methods, conclusions, limitations, and controversies among the articles is thoroughly presented.
Suggestions for Future Research
5. Excellent
Identified gaps and areas requiring further research are thoroughly discussed and clearly based on the analysis of the literature. The narrative is insightful and demonstrates an understanding of research analysis necessary for future study.

Conclusion
5. Excellent
The conclusion is well-developed and presents a clear and accurate summary statement of what was found in the literature.

Ability to Analyze (C3.2)
5. Excellent
The literature review presented demonstrates a strong ability to analyze appropriate research from databases and other information sources to improve health care practices and processes.
Appendix
5. Excellent
The APA Writing Checklist is attached in the appendix. It is clearly evident by the quality of the paper that the APA Writing Checklist was used in development.

Required Sources
5. Excellent
Number of required resources is met. Sources are current and appropriate for the assignment criteria and nursing content.
Thesis Development and Purpose
5. Excellent
Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
Argument Logic and Construction
5. Excellent
Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

Mechanics of Writing (includes spelling, punctuation, grammar, language use)
5. Excellent
Writer is clearly in command of standard, written, academic English.
Paper Format (Use of appropriate style for the major and assignment)
5. Excellent
All format elements are correct.
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
5. Excellent
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

Assignment: NUR 550 Benchmark -Evidence-Based Practice Project: Literature Review Sample

Hypertension is prevalent in about 30% of US adults.  Despite the importance of achieving optimal blood pressure (BP) control for long-term health, many patients do not attain it.  Limited English proficiency (LEP) is one of the factors associated with poor health status and health outcomes in hypertensive patients.  Non-English speakers in the US are at risk of healthcare disparities in accessing healthcare and screenings with regard to hypertension (Kim et al., 2018).  The PICOT for this problem is: In non-English speaking patients with hypertension (P), does including family as a support system while educating patients (I) compared to no family support (C) improve blood pressure (O) in six months (T)?  The purpose of this paper is to analyze peer-reviewed articles related to the PICOT question and give suggestions for future research.

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Search Methods

A literature search was conducted to identify peer-reviewed articles that support the PICOT question.  The search entailed using research databases like PubMed, MEDLINE, and Cochrane Database of Systematic Reviews.  The keywords from the PICOT were used to find the articles, and they included “non-English patients,” “family support system,” “patient education,” and “improve blood pressure  .”Furthermore, the search was limited to peer-reviewed articles published in English and those from January 2018 to date to ensure currency.  Employing the search limitations limited the number of articles retrieved and refined the search making it more precise.

Synthesis of the Literature

Maslakpak et al. (2018) examined the effectiveness of family involvement in patient education on hypertension management.  The study employed a single-blind randomized, parallel-group controlled trial using 100 patients.  The intervention group was provided interactive educational interventions comprising patient-oriented and family-oriented strategies.  The study established a significantly improved compliance to medical treatment in the patient and family-oriented group.  The study supports the PICOT since it establishes that family involvement in patient education impacts treatment compliance and patient outcomes.  Besides, it proves that family involvement enables HTN patients to adopt healthier lifestyles and better manage BP.

            Zeng et al. (2021) examined the feasibility, acceptability, and preliminary effectiveness of a theory-based patient-family carer partnership intervention for persons with HTN.  The researchers conducted a pilot RCT using pretest and post-test design and had 44 participants.  The intervention group received a five-session patient-family carer partnership intervention for ten weeks.  The study found greater improvement in the percentage of normal controlled blood pressure in the intervention group.  The articles support the PICOT by establishing that patient-family partnership intervention promoted better outcomes in HTN patients.

            Irwan et al. (2022) evaluated the impact of family involvement in the educational sessions and follow-up meetings on compliance with the low-salt diet for hypertensive older adults.  The study employed an RCT using 30 patients.  The intervention included having one family member during the educational sessions and follow-up meetings.  The intervention group had a significant increase in compliance level on the knowledge, psychomotor, and family support, as well as reduced salt concentration in food and urine excretion.  The study supports the PICOT by establishing that family involvement in educational sessions can improve low-salt diet adherence among older hypertensive adults.

Chacko and Jeemon (2020) evaluated hypertension self-care practices and their impact on BP control among hypertensive adults.  The researchers conducted a community-based, cross-sectional study with 690 participants.  Study findings showed that good family support for self-care was associated with better BP control and increased adherence to self-care activities improving BP control.  The article supports the PICOT by establishing that family support and adherence to self-care activities can be applied to promote BP control.

Jeemon et al. (2021) assessed the efficacy of targeted family-based intervention in reducing total cardiovascular risk in individuals with a family history of premature coronary heart disease.  It employed an open-label cluster RCT using 750 families.  Participants in the intervention group received a comprehensive package of interventions facilitated by non-physician health workers.  Study findings show that the intervention group achieved the primary outcome better than the control group, including optimal BP, FBS, LDLs, and tobacco cessation.  The study supports the PICOT by establishing that promoting a stable family relationship promotes positive lifestyle changes within family units, promoting better BP management.

Tutpai et al. (2021) assessed the correlation between family support and controlling BP in elderly patients.  This was a quantitative research with a cross-sectional design and used 50 hypertensive patients.  Study findings reveal a relationship between family support and controlling BP, and increased family support was linked with better BP control.  The study supports the PICOT by establishing that family is one of the main supports for elderly hypertensive patients.  Besides, family support is closely linked with drug compliance, and if improved, it supports the success of hypertension therapy.

Shahin et al. (2021) conducted a systematic review to examine the effect of patients’ social support on medication adherence in hypertensive patients.  The study found statistically significant positive associations between medication adherence and social support.  The article supports the PICOT by establishing that social support impacts medication adherence in hypertensive patients.  It shows that involving family members may promote better adherence in patients.

Shen et al. (2022) conducted a survey design to identify the contents and providers of perceived social support beneficial for improving medication adherence among hypertensive patients in China.  Participants included 903 hypertensive patients.  Optimal medication adherence was positively associated with the overall score of caregiving support.  The study supports the PICOT by demonstrating that family involvement in managing hypertensive patients increases adherence to medication, resulting in better patient outcomes. 

Comparison of articles

            The purpose of the articles revolved around examining the impact of family interventions in improving self-care practices like medication adherence and nutrition.  All the articles established that family social support effectively improved health outcomes in hypertensive patients.  In addition, the study participants were hypertensive patients, and the interventions used included family interventions.  However, the study designs employed in these articles varied.  Several studies employed RCT studies, but different types of RCTs were used like Single-blind, Pilot, and Open-label cluster.  Other designs used include systematic reviews, survey studies, and cross-sectional studies.  Besides, the sample size differed in all the articles and the settings the studies were conducted in.  Irwan et al. (2022) had the least sample size with 30 patients, while Jeemon et al. (2021) had the largest sample of 750 families with 1671 members.  The interventions provided to the intervention groups and participants varied in the studies, although the family intervention was common.  Some studies incorporated interventions like the DASH diet, physical activity, and weight.

The articles have a common theme, which is the involvement of family in hypertension management.  Conclusions were similar in all the articles, with the researchers concluding that involving family as social support in managing hypertensive patients is crucial in promoting better health outcomes.  The articles recommend including family members when providing health education to hypertensive patients, including the elderly and non-English speakers, to encourage a healthier lifestyle and better management of BP.  The small sample size used in some studies like Irwan et al. (2022) and Tutpai et al. (2021) limits the generalization of the findings.  Furthermore, the studies that applied Survey and cross-sectional designs were limited since there was no comparison of the intervention like RCTs.  Nevertheless, no controversies were identified in any of the studies. 

Suggestions for Future Research

From the literature analysis, we know that incorporating family members as part of support for hypertensive patients improves their medication adherence and self-care practices.  We also know that family interventions improve outcomes and promote optimal BP control.  However, we do not know the interventions that can be implemented to encourage family members to support hypertensive patients.  Thus, future studies should look into ways that family members can be encouraged to become involved in the management of their family members with hypertension.

Conclusion

The articles examined the impact of family involvement in improving the outcomes of hypertensive patients.  Overall study findings show that involving family members in providing health education to hypertensive patients increases compliance to treatment and contributes to better self-care practices resulting in better BP control.  Thus, the findings support the PICOT by establishing that families can be included as a support system for non-English speaking hypertensive patients, which can improve BP. 

References

Chacko, S., & Jeemon, P. (2020).  Role of family support and self-care practices in blood pressure control in individuals with hypertension: results from a cross-sectional study in Kollam District, Kerala.  Wellcome open research, 5, 180.  https://doi.org/10.12688/wellcomeopenres.16146.1

Irwan, A. M., Usman, S., & Arafat, R. (2022). Family involvement in a low-salt diet for hypertensive older adults.  Working with Older People.  https://doi.org/10.1108/WWOP-05-2021-0022

Jeemon, P., Harikrishnan, S., Ganapathi, S., Sivasankaran, S., Binukumar, B., Padmanabhan, S., … & Prabhakaran, D. (2021).  Efficacy of a family-based cardiovascular risk reduction intervention in individuals with a family history of premature coronary heart disease in India (PROLIFIC): an open-label, single-center, cluster randomized controlled trial.  The Lancet Global Health, 9(10), e1442-e1450.  https://doi.org/10.1016/S2214-109X(21)00319-3

Kim, E. J., Kim, T., Paasche-Orlow, M. K., Rose, A. J., & Hanchate, A. D. (2018). Disparities in Hypertension Associated with Limited English Proficiency.  Journal of general internal medicine, 32(6), 632–639.  https://doi.org/10.1007/s11606-018-3999-9

Maslakpak, M. H., Rezaei, B., & Parizad, N. (2018). Does family involvement in patient education improve hypertension management?  A single-blind randomized, parallel-group, controlled trial.  Cogent Medicine, 5(1), 1537063.  https://doi.org/10.1080/2331205X.2018.1537063

Shahin, W., Kennedy, G. A., & Stupans, I. (2021).  The association between social support and medication adherence in patients with hypertension: A systematic review.  Pharmacy Practice, 19(2).  https://dx.doi.org/10.18549/pharmpract.2021.2.2300

Shen, B., Guan, T., Du, X., Pei, C., Zhao, J., & Liu, Y. (2022).  Medication Adherence and Perceived Social Support of Hypertensive Patients in China: A Community-Based Survey Study.  Patient preference and adherence, 16, 1257-1268.  https://doi.org/10.2147/PPA.S363148

Tutpai, G., Unja, E. E., & Nura, F. (2021). Family Support for Controlling Blood Pressure of Elderly Patients in Health Facilities During the Covid-19 Pandemic in Banjarmasin.  KnE Life Sciences, 268-277.  https://doi.org/10.18502/kls.v6i1.8614

Zeng, D., Yang, C., & Chien, W. T. (2021). Effects of a family dyadic partnership program for people with hypertension in a rural community: A pilot randomized controlled trial.  Australian Journal of Rural Health, 29(3), 435-448.  https://doi.org/10.1111/ajr.12712