NRHL 5503 Evidence Based Nursing Practice

Question:

You should identify a research-based or evidence-based article which focuses on a specific intervention, or new diagnostic tool for treating diabetes in children and adults.

This summary will summarize the main ideas of the research findings that were made for a particular patient group.

Research should include current, thorough, relevant, and pertinent clinical findings.

Completion of the following assignments is based on the Evidence-Based ProjectaEUR “Paper on Diabetes. It contains a summary of research findings that describe a new diagnostic tool, or intervention, for the treatment of diabetes in children or adults.

Answer:

Diabetes is a medical condition where blood glucose levels are elevated.

This could be caused by an underproduction or desensitization insulin hormone (produced in the pancreas).

There are two types, Type 1 and Type 2, of diabetes.

Type 1 diabetes is caused by underproduction of insulin. This affects young children and adults. Type 2 diabetes is caused by insulin deprivation and occurs in older adults and middle-aged people.

Gestational Diabetes may also occur in pregnant women. However the effects cease after the birth.

This report provides specific evidence about one intervention that has been used for diabetes patients.

It reviews the effect of the intervention upon a particular population group to determine its relevance in nursing practice.

Summary Of The Intervention

Karstoft (2013) conducted research to determine if free walking training (specific intervention), was feasible for type 2 diabetic patients (specific population). The study focused on the effects on body composition, glycemic control, physical fitness and overall health.

It is important to focus on free walking training because it is the strongest predictor of all causes mortality in type 2 diabetic patients.

The effect of free walking training on diabetics was tested in a controlled, randomized study.

Advertising and contacting a diabetes organization helped to identify type 2 diabetic participants.

All participants underwent medical screening.

Comparing interval walking (IWT) with continuous walking (CWT) was used to assess the effectiveness.

The three groups were IWT, CWT, and control.

Each participant was assigned a pedometer, and the trainees in training had to pass a V02 speak test.

This was crucial because the research goal was to assess the effectiveness of IWT versus CWT in terms of energy expenditure. The VO2 peak testing was used to measure the energy expenditure.

In the IWT, subjects had to walk for 3 minutes at a fast pace and then for 3 minutes at a slower pace.

The CWT groups had to achieve CWT higher than the target.

Each training session lasted for 4 months, and the participants were required to complete 60 minutes each week (Karstoft and al., 2013).

The study concluded that IWT was more efficient than CWT in improving body composition and physical fitness, as well as glyecmic control.

Although physical fitness levels showed improvement in the training group, this was not seen in the CWT or IWT groups.

CWT group also had no change in body composition or glycemic controls (Karstoft et.al., 2013).

Interval walking training is an effective intervention for type 2 diabetic patients.

Evaluation of The Study

In type 2 diabetes patients, free walking or training programs are highly valued.

One limitation of studies supporting free walking intervention is that only minor benefits were found in diabetic patients (Morton, et al. 2010).

This could indicate that the intensity of such training may be affecting the outcome.

The opposite result was found in high intensity training programs for diabetic patients. However, it was limited due to feasibility issues found by many research (Little et al. 2011, Gillen & Gibala 2013.

These interventions cannot be carried out without the supervision of experts.

Therefore, it was necessary to develop interventions that can improve the health outcomes of diabetic patients as well as be accessible by all adult patients.

Karstoft (2013)’s research is important because it examined the intensity of walking and evaluated the effect of interval walking, which is a repetitive cycle of slow walking and fast walking.

Research in this area focuses on the feasibility and effects of such interventions.

Karstoft (2013) and others proved that IWT is effective in treating diabetic patients. This was based on energy expenditure, improvement of symptoms, and feasibility for the targeted population.

This evidence provides new guidance to consider IWT as an intervention for type 2 diabetic patients.

It’s also applicable to nursing practice, as nurses can use such intervention in support of diabetic patients in primary healthcare to lead a healthy lifestyle.

Sargent, Forrest, and Parker (2012) showed that primary health nurses provide extensive advice on lifestyle changes and chronic disease management.

Nurses can assist diabetic patients by being part of a multidisciplinary primary healthcare team.

This will help prevent diabetes, improve physical fitness, and control glycaemia.

American Diabetes Association.

Diagnosis and classification of diabetes.

Diabetes care 38(Supplement 1), S8-S16.

Is high-intensity training an efficient exercise strategy to improve fitness and health?

Applied Physiology, Nutrition and Metabolism, 3(3), 409-412.

Free-living interval-walking training has been shown to improve glycemic control, body composition, physical fitness, and overall health in type 2 diabetics.

Diabetes Care, 36(2), 228-236.

Training with low-volume, high-intensity intervals reduces hyperglycemia in type 2 diabetics and increases muscle mitochondrial capability.

Journal of applied physiology. 111(6). 1554-1560.

Walking at a heart rate that is prescribed improves cardiorespiratory fitness in type 2 diabetics, but does not improve glycaemic control.

Journal of sports science, 28(1), 95-99.

The systematic review of Nurse-assisted lifestyle interventions in primary healthcare to treat chronic disease risk factors linked with obesity.

Review of obesity, 13(12), 1148-1171.