Matilda Aidoo
Liberty University
BUSI619: Quality Assessment and Evidence Based Decision Making
19 May 2024
Respectfully Submitted to Dr. Jean Gordon
2
Adult Type 2 Diabetes Patients’ Glycemic Control and Regular Exercise
Evidence-based practice (EBP) is crucial in healthcare, as clinical decisions should be based on the most recent evidence. The PICO framework (Population, Intervention, Comparison, Outcome) is helpful because it ensures precise research questions are formulated, making a literature search and clinical decisions efficient. This piece of work is meant to show the use of the PICO framework in the EBP con, thus highlighting the contribution of the latter (Elsevier Author Services, 2024). This step allows for creating a targeted research question that can then be used to identify optimal literature review and deliver relevant findings, which, in turn, is needed to enhance patient outcomes and inform clinical practice.
Defining the PICO Components
Population: The study design involves a general population of adult people diagnosed with type 2 diabetes.
Intervention: The targeted intervention includes a structured exercise program and nutritional
counselling.
Comparison: The study contrasts this intervention with standard care, which usually entails
general information about physical activities and diet but no structured program.
Outcome: The significant outcomes we monitor encompass better glycemic control (HbA1c
levels), reduced weight, and improved quality of life (Irnawan & Syahrul, 2020). The
secondary endpoints may also include measuring whether the participants would alter their
medication regimen or increase the incidents of complications linked to diabetes.
3
Formulating the Research Question
In adult patients with type 2 diabetes (Population), does a structured exercise program
combined with dietary counselling (Intervention) compared to standard care (Comparison)
improve glycemic control, weight, and quality of life (Outcome)?
Literature Search Strategy
The literature search employed keywords such as “type 2 diabetes,” “ordered exercise
program,” “dietary counselling,” “blood sugar management,” “weight loss,” and “life quality.”
“All guidelines, systematic reviews, meta-analyses, critically appraised research studies, and
individual studies were considered in search of compelling and convincing evidence. Databases
covered were EBSCO, PubMed, ProQuest, and CINAHL with Full Text, as well as other
academic information outlets, where only those relevant and reliable records submitted to the
databases and journals were included.
Analysis of the Literature
The chosen studies give a clear account of interventions for improving diabetes quality
of life and management of type 2 diabetes distress. The works of Irnawan and Syahrul (2020)
revealed that coaching has a remarkable effect in bringing down HbA1c levels, suggesting that
it is an effective means of glycemic control. Cruz-Cobo and Santi-Cano (2020) also found that
individual training mainly decreases HbA1c, and group training validates BMI, blood pressure,
and cholesterol levels. As Vieira et al. (2020) noted, technology interventions are helpful in
dealing with diabetes distress and are even more effective when combined with individualized
feedback and caregiver support. Park et al. (2024) revealed that the high distress of diabetes is
linked with uncontrolled blood sugar levels and increased diabetic neuropathy, showcasing the
importance of psychological factors. The ADA’s Standards of Care entrust total management
of type 1 diabetes to patients through a comprehensive treatment strategy comprising clinical
4
and psychological interventions (ElSayed et al., 2023). Together, research studies prove the
efficiency of structured interventions over standard care. There are several associated benefits,
including better glycemic control and overall health.
Discussion
The analysis attests to why practice informed by science is integral to diabetes type 2
management. According to Irnawan and Syahrul (2020) and Cruz?Cobo and Santi?Cano
(2020), coaching, with educational interventions, is vital in improving glycemic control and
other health outcomes. The technology interventions also appear to be effective in decreasing
diabetes distress and improving patients’ engagement and self-management (Vieira et al.,
2020). Conversely, this heterogeneity in study designs and sample sizes can influence
subsequent identification of common outcome patterns. Apart from this, most of the study
essays focus on short-term outcomes, which is why research on the long-term effects of outputs
is required (Park et al., 2024). The result reveals that incorporating personalized coaching,
education, and technological-based interventions must be an integral part of diabetes
management. These strategies are likely to achieve higher levels of glycemic control, reduced
distress, and better QoL for the patients (ElSayed et al., 2023). The impact on the population
could be positive, and they would be able to provide better diabetes care through integration
and efficiency.
Managing type 2 diabetes through coaching, education, and technology aligns with
Biblical principles of stewardship and caring for the body, as reflected in 1 Corinthians 6:1920 (NIV), which says that we should consider our body as the temple of the Lord. From a
Biblical perspective, ethical considerations include compassion and support for those suffering;
as Jesus taught in Matthew 25:36 (NIV), “When I was sick you visited me.” These measures
show that we respect Christ’s principle of loving your neighbour as you love yourself.
5
Conclusion
Finally, this discussion shows how the application of the PICO framework guides
evidence-based practice of type 2 diabetes management. Through the systematic approach
comprising the Population, Intervention, Comparison, and Outcome, researchers can create
well-formulated research questions, do extensive literature reviews, and contribute to
improving patient outcomes. The literature review illustrates that structured interventions such
as coaching, education, and technology lower blood sugar levels and improve general wellness.
Future studies need to rectify the gaps in previous studies, remarkably the variability in study
designs and short-term outcomes, and provide more convincing evidence for clinical practice.
These results could drive the implementation of better management strategies that go beyond
diabetes treatment.
6
References
Bible, H. (2020). New International Version, NIV Copyright 1973, 1978, 1984, 2011 by
Biblica, Inc. Used by permission. All rights reserved worldwide.
Cruz?Cobo, C., & Santi?Cano, M. J. (2020). Efficacy of diabetes education in adults with
diabetes mellitus type 2 in primary care: a systematic review. Journal of Nursing
Scholarship, 52(2), 155-163. https://doi.org/10.1111/jnu.12539
ElSayed, N. A., Aleppo, G., Bannuru, R. R., Beverly, E. A., Bruemmer, D., Collins, B. S., Cusi,
K., Darville, A., Das, S. R., Ekhlaspour, L., Fleming, T. K., Gaglia, J. L., Galindo, R.
J., Gibbons, C. H., Giurini, J. M., Hassanein, M., Hilliard, M. E., Johnson, E. L., Khunti,
K., . . . Gabbay, R. A. (2023). Introduction and Methodology: Standards of Care in
Diabetes—2024.
Diabetes
Care,
47(Supplement_1),
S1–S4.
https://doi.org/10.2337/dc24-sint
Elsevier Author Services. (2023, August 4). Clinical questions: PICO and PEO Research |
Elsevier
blog.
Elsevier
Author
Services
–
Articles.
https://scientific-
publishing.webshop.elsevier.com/research-process/clinical-questions-pico-and-peoresearch/
Irnawan, S. M., & Syahrul, S. (2020). Effect of coaching on glycemic control among type 2
diabetes mellitus patients: A literature review. Enfermería Clínica, 30, 158–162.
https://doi.org/10.1016/j.enfcli.2019.07.068
Park, H., Cho, Y., Seo, D. H., Ahn, S. H., Hong, S., Suh, Y. J., Chon, S., Woo, J., Baik, S. H.,
Lee, K. W., & Kim, S. H. (2024). Impact of diabetes distress on glycemic control and
diabetic complications in type 2 diabetes mellitus. Scientific Reports, 14(1).
https://doi.org/10.1038/s41598-024-55901-0
7
Vieira, P., Kobayasi, R., Pereira, F., Zaia, I. M., & Sasaki, S. U. (2020). Impact of technology
use in type 2 diabetes distress: A systematic review. World Journal of Diabetes, 11(10),
459–467. https://doi.org/10.4239/wjd.v11.i10.459
LITERATURE REVIEW: PART 1 – MATRIX ASSIGNMENT INSTRUCTIONS
OVERVIEW
The purpose of creating a literature matrix for research is to help you organize your thoughts and
to begin the analysis and critique process. Publishing an article does not mean that it is
appropriate for your consideration in your particular discipline project. One needs to be able to
evaluate the published work based on the quality of the research design and on its relevant merit
for your question. The matrix is similar to a comprehensive note card and should contain the
basic information of the research. You are creating a shortcut version of the key elements of the
article to use in synthesizing the literature.
INSTRUCTIONS
Items to include are outlined as follows:
• 1-2 pages in length utilizing the template
• APA format
• 5 peer-reviewed citations
• Acceptable sources
o Scholarly articles published within the last five years
Review the Literature Review: Part 1 – Matrix Template and complete the following:
1. Search the databases noted in the Population, Intervention, Comparison, Outcome
(PICO) Assignment and locate 5 peer reviewed research articles that align with your
PICO question.
2. For each article fill in the banks in the template:
a. APA formatted citation
b. Purpose of the study
i. One short paragraph using complete sentences.
c. Level of Evidence
i. Identify the level and provide your rationale for choosing the level
d. Study Results
i. One short paragraph using complete sentences
e. Practice Implications with Biblical Integration
i. One short paragraph using complete sentences
ii. Suggesting how the article impacts the problem stated in the PICO
Question and incorporates Biblical verse
3. Note: Your assignment will be checked for originality via the Turnitin plagiarism tool.
Literature Review: Part 1 – Matrix Template
Article Information
(citation in current
APA format)
Purpose of the Study
Level of Evidence
Study Results
Practice Implications
with Biblical
Integration
Matilda Aidoo
Liberty University
BUSI619: Quality Assessment and Evidence Based Decision Making
19 May 2024
Respectfully Submitted to Dr. Jean Gordon
2
Adult Type 2 Diabetes Patients’ Glycemic Control and Regular Exercise
Evidence-based practice (EBP) is crucial in healthcare, as clinical decisions should be
based on the most recent evidence. The PICO framework (Population, Intervention,
Comparison, Outcome) is helpful because it ensures precise research questions are formulated,
making a literature search and clinical decisions efficient. This piece of work is meant to show
the use of the PICO framework in the EBP con, thus highlighting the contribution of the latter
(Elsevier Author Services, 2024). This step allows for creating a targeted research question that
can then be used to identify optimal literature review and deliver relevant findings, which, in
turn, is needed to enhance patient outcomes and inform clinical practice.
Defining the PICO Components
Population: The study design involves a general population of adult people diagnosed with
type 2 diabetes.
Intervention: The targeted intervention includes a structured exercise program and nutritional
counselling.
Comparison: The study contrasts this intervention with standard care, which usually entails
general information about physical activities and diet but no structured program.
Outcome: The significant outcomes we monitor encompass better glycemic control (HbA1c
levels), reduced weight, and improved quality of life (Irnawan & Syahrul, 2020). The
secondary endpoints may also include measuring whether the participants would alter their
medication regimen or increase the incidents of complications linked to diabetes.
3
Formulating the Research Question
In adult patients with type 2 diabetes (Population), does a structured exercise program
combined with dietary counselling (Intervention) compared to standard care (Comparison)
improve glycemic control, weight, and quality of life (Outcome)?
Literature Search Strategy
The literature search employed keywords such as “type 2 diabetes,” “ordered exercise
program,” “dietary counselling,” “blood sugar management,” “weight loss,” and “life quality.”
“All guidelines, systematic reviews, meta-analyses, critically appraised research studies, and
individual studies were considered in search of compelling and convincing evidence. Databases
covered were EBSCO, PubMed, ProQuest, and CINAHL with Full Text, as well as other
academic information outlets, where only those relevant and reliable records submitted to the
databases and journals were included.
Analysis of the Literature
The chosen studies give a clear account of interventions for improving diabetes quality
of life and management of type 2 diabetes distress. The works of Irnawan and Syahrul (2020)
revealed that coaching has a remarkable effect in bringing down HbA1c levels, suggesting that
it is an effective means of glycemic control. Cruz-Cobo and Santi-Cano (2020) also found that
individual training mainly decreases HbA1c, and group training validates BMI, blood pressure,
and cholesterol levels. As Vieira et al. (2020) noted, technology interventions are helpful in
dealing with diabetes distress and are even more effective when combined with individualized
feedback and caregiver support. Park et al. (2024) revealed that the high distress of diabetes is
linked with uncontrolled blood sugar levels and increased diabetic neuropathy, showcasing the
importance of psychological factors. The ADA’s Standards of Care entrust total management
of type 1 diabetes to patients through a comprehensive treatment strategy comprising clinical
4
and psychological interventions (ElSayed et al., 2023). Together, research studies prove the
efficiency of structured interventions over standard care. There are several associated benefits,
including better glycemic control and overall health.
Discussion
The analysis attests to why practice informed by science is integral to diabetes type 2
management. According to Irnawan and Syahrul (2020) and Cruz?Cobo and Santi?Cano
(2020), coaching, with educational interventions, is vital in improving glycemic control and
other health outcomes. The technology interventions also appear to be effective in decreasing
diabetes distress and improving patients’ engagement and self-management (Vieira et al.,
2020). Conversely, this heterogeneity in study designs and sample sizes can influence
subsequent identification of common outcome patterns. Apart from this, most of the study
essays focus on short-term outcomes, which is why research on the long-term effects of outputs
is required (Park et al., 2024). The result reveals that incorporating personalized coaching,
education, and technological-based interventions must be an integral part of diabetes
management. These strategies are likely to achieve higher levels of glycemic control, reduced
distress, and better QoL for the patients (ElSayed et al., 2023). The impact on the population
could be positive, and they would be able to provide better diabetes care through integration
and efficiency.
Managing type 2 diabetes through coaching, education, and technology aligns with
Biblical principles of stewardship and caring for the body, as reflected in 1 Corinthians 6:1920 (NIV), which says that we should consider our body as the temple of the Lord. From a
Biblical perspective, ethical considerations include compassion and support for those suffering;
as Jesus taught in Matthew 25:36 (NIV), “When I was sick you visited me.” These measures
show that we respect Christ’s principle of loving your neighbour as you love yourself.
5
Conclusion
Finally, this discussion shows how the application of the PICO framework guides
evidence-based practice of type 2 diabetes management. Through the systematic approach
comprising the Population, Intervention, Comparison, and Outcome, researchers can create
well-formulated research questions, do extensive literature reviews, and contribute to
improving patient outcomes. The literature review illustrates that structured interventions such
as coaching, education, and technology lower blood sugar levels and improve general wellness.
Future studies need to rectify the gaps in previous studies, remarkably the variability in study
designs and short-term outcomes, and provide more convincing evidence for clinical practice.
These results could drive the implementation of better management strategies that go beyond
diabetes treatment.
6
References
Bible, H. (2020). New International Version, NIV Copyright 1973, 1978, 1984, 2011 by
Biblica, Inc. Used by permission. All rights reserved worldwide.
Cruz?Cobo, C., & Santi?Cano, M. J. (2020). Efficacy of diabetes education in adults with
diabetes mellitus type 2 in primary care: a systematic review. Journal of Nursing
Scholarship, 52(2), 155-163. https://doi.org/10.1111/jnu.12539
ElSayed, N. A., Aleppo, G., Bannuru, R. R., Beverly, E. A., Bruemmer, D., Collins, B. S., Cusi,
K., Darville, A., Das, S. R., Ekhlaspour, L., Fleming, T. K., Gaglia, J. L., Galindo, R.
J., Gibbons, C. H., Giurini, J. M., Hassanein, M., Hilliard, M. E., Johnson, E. L., Khunti,
K., . . . Gabbay, R. A. (2023). Introduction and Methodology: Standards of Care in
Diabetes—2024.
Diabetes
Care,
47(Supplement_1),
S1–S4.
https://doi.org/10.2337/dc24-sint
Elsevier Author Services. (2023, August 4). Clinical questions: PICO and PEO Research |
Elsevier
blog.
Elsevier
Author
Services
–
Articles.
https://scientific-
publishing.webshop.elsevier.com/research-process/clinical-questions-pico-and-peoresearch/
Irnawan, S. M., & Syahrul, S. (2020). Effect of coaching on glycemic control among type 2
diabetes mellitus patients: A literature review. Enfermería Clínica, 30, 158–162.
https://doi.org/10.1016/j.enfcli.2019.07.068
Park, H., Cho, Y., Seo, D. H., Ahn, S. H., Hong, S., Suh, Y. J., Chon, S., Woo, J., Baik, S. H.,
Lee, K. W., & Kim, S. H. (2024). Impact of diabetes distress on glycemic control and
diabetic complications in type 2 diabetes mellitus. Scientific Reports, 14(1).
https://doi.org/10.1038/s41598-024-55901-0
7
Vieira, P., Kobayasi, R., Pereira, F., Zaia, I. M., & Sasaki, S. U. (2020). Impact of technology
use in type 2 diabetes distress: A systematic review. World Journal of Diabetes, 11(10),
459–467. https://doi.org/10.4239/wjd.v11.i10.459