Theoretical and Scientific Foundations of Nursing
Discussion
3 years ago 20
Abstract_for_primary_source_research_article.pdf
Discussion.docx
Abstract_for_secondary_source_article.pdf
practiceissue.docx
EvidenceSynthesisandRecommendationForm.pdf
Abstract_for_primary_source_research_article.pdf
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School Counselors' Strategies for Social Justice Change: A Grounded Theory of What Works in the Real World Singh, Anneliese A, PhD; Urbano, Alessandra; Haston, Meg; M
cMahon, Eleanor.
Professional School Counseling; Alexandria Vol. 13, lss. 3,
(Feb 2010) : 135-145.
Full text Full text - PDF Abstract/Details
References 31
Abstract Translate
A qualitative study used a grounded theory methodology to explore the
strategies that 16 school counselors who self-identified as social justice
agents used to advocate for systemic change within their school
communities. Findings included seven overarching themes: (a) using
political savvy to navigate power structures, (b) consciousness raising, (c)
initiating difficult dialogues, (d) building intentional relationships, (e)
teaching students self-advocacy skills, (f) using data for marketing, and (g)
educat ing others about the school counselor role of advocate.
[PUBLICATION ABSTRACT]
Discussion.docx
Discussion
FRAMING A PRACTICE PROBLEM AS A CRITICAL QUESTION WITH MEASURABLE OUTCOMES
Throughout this course you have focused on practice problems to address in applying nursing and interdisciplinary theories, and in the application of evidence-based practice for quality improvement. This week you begin exploring the components of evidence-based practice by framing a practice problem as a critical question. You will begin a search of the literature for evidence to answer the question and inform a practice change for quality improvement.
TO PREPARE:
· Identify the practice problem as the focus of your Discussion post. You may use the same practice problem from earlier weeks or a different one.
· Review the chapter on practice questions in the Dang and Dearholt text and the Week 7 Media. With guidance from the Learning Resources, cast your practice problem as a critical question.
· Search the Walden Library for 4-5 scholarly articles that address your critical question.
· View the resource for synthesizing the evidence found in week 7 learning resources. Share the component of the evidence synthesis process that resonated with you. Explain how that component is reflected in your synthesis of the evidence (articles you selected to support your practice problem and critical question).
· Analyze the articles to identify evidence that would guide quality improvement.
· Return to the stakeholders that were the audience for your Module 3 Assignment. Identify the specific quality improvement component in the evidence. Then consider how you would present it to that set of stakeholders to secure agreement and action.
With these thoughts in mind …
Post a brief explanation of your critical question. Then, synthesize the 4-5 articles you identified that address your critical question. Using the same language you would use with stakeholders, explain the critical question and the value of addressing it as a quality improvement initiative. Be specific. Cite the scholarly articles and other resources to support your post.
Abstract_for_secondary_source_article.pdf
Abstract: Unlabelled: POLICY POINTS: Many barriers hamper advocacy for health equity, im contemporary economic zeitgeist, the biomedical health perspective, and difficulties across policy sectors on the issue. Effective advocacy should include persistent effo awareness and understanding of the social determinants of health. Education on the determinants as part of medical training should be encouraged, including profession within disadvantaged communities. Advocacy organizations have a central role in ac health equity g iven the challenges bridging the worlds of civil society, research, and Context: Health inequalities are systematic differences in health among social grou1 caused by unequal exposure to-and distributions of-the social determinants of healtt are persistent between and within countries despite action to reduce them. Advocac of promoting policies that improve health equity, but the literature on how to do so ef dispersed. The aim of1nis review is to synt es1ze tlie eviaence int e acaaemic ana literature and to provide a body of knowledge for advocates to draw on to inform the Methods: This article is a systematic review of the academic literature and a fixed-IE systematic search of the gr.ay literature. After applying our inclusion criteria, we anal findings according to our predefined dimensions of advocacy for health equity. Last, sy:nthesized our findings and made a critical appraisal of the literature. Findings: The policy world is complex, and scientific evidence is unlikely to be cone making decisions. Timely qualitative, interdisciplinary, and mixed-methods research valuable in advocacy efforts. The potential impact of evidence can be increased by" as part of knowledge transfer and translation. Increased contact between researche policymakers could improve the uptake of research in policy processes. Researcher role in advocacy efforts, although health professionals and disadvantaged people, w direct contact with or experience of hardship, can be particularly persuasive in advo< Different types of advocacy messages can accompany evidence, but messages sho tailored to advocacy target. Several barriers hamper advocacy efforts. The most free in the academic literature are the current political and economic zeitgeist and relatec opinion, which tend to blame disadvantaged people for their ill health, even though t approaches to health and political short-termism also act as barriers. These barriers tackled through long-term actions to raise public awareness and understanding of th through training of health professionals in advocacy. Advocates need to take advant "windows of opportun ity," which open and close quickly, and demonstrate expertise; Conclusions: This article brings together for the first time evidence from the acader gra literature and ~rovides a building block for efforts to advocate for health eguity. regarding many of the dimensions is scant, and additional research is merited, partic concerning the applicability of findings outside the English-speaking wor1d. AdvocaC' organizations have a central role in advocating for health equity, given the challenge worlds of civil society, research, and policy. (© 2015 The Authors. The Milbank Quarterly published by Wiley Periodicals, Inc. on Milbank Memorial Fund.)
:foding the cooperating rts to raise ~social al training jvocating for policy. :>s that are 1 (SDH). They y is a means fectively is gray ir efforts. mgth yzed our we
:lusive in may be 'packaging" it rs and scan play a ·ho have ::acy efforts. ·Uld be 1uently cited J public >iomedical could be
1e SDH and age of and credibility. nic and the Evidence ~ularly y s bridging the
behalf of The
practiceissue.docx
1
assignment
EXPLORING EBP QUALITY IMPROVEMENT
· PRACTICE ISSUE: BIPOLAR DISORDER
· REMEMBER TO USE APA: Writing, sentence structure.
· Please insert (intext citations) citations throughout the paper.
· Clearly state the specific theory/ apply theory to practice.
Your previous paper on this practice issue
Application of Middle Range Theories to the Care of Individuals with Bipolar
Bipolar disorder, initially referred to as manic depression, is a mental health illness whereby individuals exhibit extreme mood swings, including emotional highs (mania or hypomania) and lows (depression). The condition can severely impact an individual’s daily life; however, the effects vary between individuals. The Nation Alliance of Mental Illness reported that over 10 million Americans have bipolar, accounting for 2.8% of the population (McIntyre et al., 2020).
Middle range theories play an instrumental role in nursing, improving practice and quality of life. Several middle range nursing theories can be applied to the care of individuals with bipola. The theories offer nurses a framework for understanding and addressing the complex needs of these individuals. The self-regulation model, developed by Pender, Murdaugh, And Parsons, is an effective theory. Also known as the health promotion model, the theory describes health as a state characterized by positive dynamics instead only the absence of illness (Younas & Quennell, 2019). The health promotion model aims to enhance the overall well-being of individuals, which is why it is effective in helping individuals manage bipolar. The model notes the multifaceted character of individuals as they interact with their environments to achieve health.
Pender's model is categorized into three factors: individual features and experiences, cognitions and behavior-related feelings, and behavioral consequences (Gorbani et al., 2020). According to the theory, every individual has different personal features and experiences that impact later behaviors. The set of behavior-specific knowledge and affect factors holds significant motivational value. Nursing activities can be employed to alter the variables. This model's end-point is to promote healthy behavior (Gorbani et al., 2020).
The self-regulation model stresses the significance of promoting and maintaining health. Following the model, nurses can develop strategies significant in helping individuals with bipolar manage mood swings, follow recommended medications, and adopt a healthy lifestyle supporting mood stability. According to the self-regulation model, people are more likely to embrace health-promoting behaviors when significant others direct their behavior and offer the necessary assistance and support to facilitate the behavior (Younas & Quennell, 2019). Nurses are considered significant in health care provision and can effectively promote positive and health-promoting behavior among people with bipolar disorder. Besides, another theoretical statement deduced from the self-regulation model, which provides a foundation for investigative work on health behaviors, is that families, friends, and healthcare providers are significant interpersonal influences that can either enhance or limit engagement in behaviors that promote health (Younas & Quennell, 2019). The statement implies that through proper interventions, nurses can help promote healthy behaviors among these individuals. Nurses can work closely with family members of bipolar individuals to enhance the achievement of positive outcomes.
The self-regulation model highlights the roles of self-efficacy in promoting health behaviors. Nurses can improve bipolar individuals’ self-efficacy in managing the condition by closely working with them. Enhancing self-efficacy can involve teaching the individuals how to cope with the condition, providing education about the condition, and helping individuals set realistic goals necessary in managing their mental health.
Another model that nurses can apply to bipolar care is the Chronic Care Model. The theory emphasizes the significance of individual-centered care, self-management support, and healthcare team collaboration in managing chronic conditions like bipolar (Ortiz, 2021). The model was developed by a group of researchers led by Ed Wagner. Self-management support, a component of the model, posits that nurses should empower and prepare individuals to manage their health. According to self-management support, nurses should recognize that individuals play a central role in managing their health. While treating bipolar individuals, nurses need to involve individuals in the care and tailor treatment plans to their preferences. It implies considering individual goals of individuals in managing the condition.
Besides, nurses need to employ effective self-management support approaches, including goal-setting, action planning, and follow-up. Through self-management support, nurses can provide bipolar individuals with the resources and support necessary to manage their conditions. It includes educating individuals on mood monitoring, medication management, and coping strategies. Another critical component of the Chronic Care Model is using scientific evidence to support decisions (Ortiz, 2021). While developing appropriate interventions for individuals with bipolar, nurses base their decisions on evidence-based guidelines.
References
Gorbani, F., Mahmoodi, H., Sarbakhsh, P., & Shaghaghi, A. (2020). Predictive performance of pender’s health promotion model for hypertension control in iranian individuals. Vascular health and risk management, 299-305.
McIntyre, R. S., Berk, M., Brietzke, E., Goldstein, B. I., López-Jaramillo, C., Kessing, L. V., ... & Mansur, R. B. (2020). Bipolar disorders. The Lancet, 396(10265), 1841-1856.
Ortiz, M. R. (2021). Best Practices in Individual-Centered Care: Nursing Theory Reflections. Nursing Science Quarterly, 34(3), 322-327.
Younas, A., & Quennell, S. (2019). Usefulness of nursing theory‐guided practice: An integrative review. Scandinavian journal of caring sciences, 33(3), 540-555.
EvidenceSynthesisandRecommendationForm.pdf
© 2017 The Johns Hopkins Hospital/ Johns Hopkins University School of Nursing
Synthesis Process and Recommendations Tool
Key Points:
• Evidence synthesis is best done through group discussion. All team members share
their perspectives, and the team uses critical thinking to arrive at a judgment based
on consensus during the synthesis process. The synthesis process involves both
subjective and objective reasoning by the full EBP team. Through reasoning, the
team:
▪ Reviews the quality appraisal of the individual pieces of evidence
▪ Assesses and assimilates consistencies in findings
▪ Evaluates the meaning and relevance of the findings
▪ Merges findings that may either enhance the team’s knowledge or
generate new insights, perspectives, and understandings
▪ Highlights inconsistencies in findings
▪ Makes recommendations based on the synthesis process
• When evidence includes multiple studies of Level I and Level II evidence, there is
a similar population or setting of interest, and there is consistency across findings,
EBP teams can have greater confidence in recommending a practice change.
However, with a majority of Level II and Level III evidence, the team should
proceed cautiously in making practice changes. In this instance,
recommendation(s) typically include completing a pilot before deciding to
implement a full-scale change.
• Generally, practice changes are not made on Level IV or Level V evidence alone.
Nonetheless, teams have a variety of options for actions that include, but are not
limited to: creating awareness campaigns, conducting informational and educational
updates, monitoring evidence sources for new information, and designing research
studies.
© 2017 The Johns Hopkins Hospital/ Johns Hopkins University School of Nursing
• The quality rating (see Appendix D) is used to appraise both individual quality of
evidence and overall quality of evidence.
© 2017 The Johns Hopkins Hospital/ Johns Hopkins University School of Nursing
Date:
EBP Question:
Article
Number
Author and Date
Evidence Type
Sample, Sample
Size, Setting
Findings That
Help Answer the EBP Question
Observable Measures
Limitations
Evidence Level,
Quality
Johns Hopkins Nursing Evidence-Based Practice
Appendix H Synthesis Process and Recommendations Tool
© 2017 The Johns Hopkins Hospital/ Johns Hopkins University School of Nursing
EBP Question:
Category (Level Type) Total Number of Sources/Level
Overall Quality Rating
Synthesis of Findings Evidence That Answers the EBP Question
Level I
▪ Experimental study ▪ Randomized controlled trial (RCT)
▪ Systematic review of RCTs with or without meta-analysis
▪ Explanatory mixed method design that includes only a Level I quaNtitative study
Level II
▪ Quasi-experimental studies
▪ Systematic review of a combination of RCTs and quasi-experimental studies, or quasi- experimental studies only, with or without meta-analysis
▪ Explanatory mixed method design that includes only a Level II quaNtitative study
Level III
▪ Nonexperimental study ▪ Systematic review of a combination of RCTs,
quasi-experimental and nonexperimental studies, or nonexperimental studies only, with or without meta- analysis
▪ QuaLitative study or meta- synthesis
▪ Exploratory, convergent, or multiphasic mixed-methods studies
▪ Explanatory mixed method design that includes only a level III QuaNtitative study
Johns Hopkins Nursing Evidence-Based Practice
Appendix H Synthesis Process and Recommendations Tool
© 2017 The Johns Hopkins Hospital/ Johns Hopkins University School of Nursing
Category (Level Type) Total Number of Sources/Level
Overall Quality Rating
Synthesis of Findings
Evidence That Answers the EBP Question
Level IV
▪ Opinions of respected authorities and/or reports of nationally recognized expert committees or consensus panels based on scientific evidence
Level V
▪ Evidence obtained from literature or integrative reviews, quality improvement, program evaluation, financial evaluation, or case reports
▪ Opinion of nationally recognized expert(s) based on experiential evidence
Johns Hopkins Nursing Evidence-Based Practice
Appendix H Synthesis Process and Recommendations Tool
© 2017 The Johns Hopkins Hospital/ Johns Hopkins University School of Nursing
Based on your synthesis, which of the following four pathways to translation represents the overall strength of the evidence?
❑Strong, compelling evidence, consistent results: Solid indication for a practice change is indicated.
❑Good and consistent evidence: Consider pilot of change or further investigation.
❑Good but conflicting evidence: No indication for practice change; consider further investigation for new evidence or develop a research study.
❑Little or no evidence: No indication for practice change; consider further investigation for new evidence, develop a research study, or discontinue project.
If you selected either the first option or the second option, continue. If not, STOP , translation is not indicated.
Recommendations based on evidence synthesis and selected translation pathway
Consider the following as you examine fit:
Are the recommendations:
▪ Compatible with the unit/departmental/organizational cultural values or norms?
▪ Consistent with unit/departmental/organizational assumptions, structures, attitudes, beliefs, and/or
practices?
▪ Consistent with the unit/departmental/organizational priorities?
Consider the following as you examine feasibility:
▪ Can we do what they did in our work environment?
▪ Are the following supports available?
• Resources
• Funding
• Approval from administration and clinical leaders
• Stakeholder support
• Is it likely that the recommendations can be implemented within the unit/department/organization?
Johns Hopkins Nursing Evidence-Based Practice
Appendix H Synthesis Process and Recommendations Tool
© 2017 The Johns Hopkins Hospital/ Johns Hopkins University School of Nursing
Directions for Use of This Form
Purpose of form
Use this form to compile the results of the individual evidence appraisal to answer the EBP question. The
pertinent findings for each level of evidence are synthesized, and a quality rating is assigned to each level.
Total number of sources per level
Record the number of sources of evidence for each level.
Overall quality rating
Summarize the overall quality of evidence for each level. Use Appendix D to rate the quality of evidence.
Synthesis of findings: evidence that answers the EBP question
• Include only findings from evidence of A or B quality.
• Include only statements that directly answer the EBP question.
• Summarize findings within each level of evidence.
• Record article number(s) from individual evidence summary in parentheses next to each statement
so that the source of the finding is easy to identify.
Develop recommendations based on evidence synthesis and the selected translation pathway
Review the synthesis of findings and determine which of the following four pathways to translation
represents the overall strength of the evidence:
• Strong, compelling evidence, consistent results: Solid indication for a practice change.
• Good and consistent evidence: Consider pilot of change or further investigation.
• Good but conflicting evidence: No indication for practice change; consider further investigation for
new evidence or develop a research study.
• Little or no evidence: No indication for practice change; consider further investigation for new
evidence, develop a research study, or discontinue the project.
Fit and feasibility
Even when evidence is strong and of high quality, it may not be appropriate to implement a change in
practice. It is crucial to examine feasibility that considers the resources available, the readiness for
change, and the balance between risk and benefit. Fit refers to the compatibility of the proposed change
with the organization’s mission, goals, objectives, and priorities. A change that does not fit within the
organizational priorities will be less likely to receive leadership and financial support, making success
difficult. Implementing processes with a low likelihood of success wastes valuable time and resources on
efforts that produce negligible benefits.
Johns Hopkins Nursing Evidence-Based Practice
Appendix H Synthesis Process and Recommendations Tool
© 2017 The Johns Hopkins Hospital/ Johns Hopkins University School of Nursing
References
Abstract_for_primary_source_research_article.pdf
< Back to results
School Counselors' Strategies for Social Justice Change: A Grounded Theory of What Works in the Real World Singh, Anneliese A, PhD; Urbano, Alessandra; Haston, Meg; M
cMahon, Eleanor.
Professional School Counseling; Alexandria Vol. 13, lss. 3,
(Feb 2010) : 135-145.
Full text Full text - PDF Abstract/Details
References 31
Abstract Translate
A qualitative study used a grounded theory methodology to explore the
strategies that 16 school counselors who self-identified as social justice
agents used to advocate for systemic change within their school
communities. Findings included seven overarching themes: (a) using
political savvy to navigate power structures, (b) consciousness raising, (c)
initiating difficult dialogues, (d) building intentional relationships, (e)
teaching students self-advocacy skills, (f) using data for marketing, and (g)
educat ing others about the school counselor role of advocate.
[PUBLICATION ABSTRACT]
Discussion.docx
Discussion
FRAMING A PRACTICE PROBLEM AS A CRITICAL QUESTION WITH MEASURABLE OUTCOMES
Throughout this course you have focused on practice problems to address in applying nursing and interdisciplinary theories, and in the application of evidence-based practice for quality improvement. This week you begin exploring the components of evidence-based practice by framing a practice problem as a critical question. You will begin a search of the literature for evidence to answer the question and inform a practice change for quality improvement.
TO PREPARE:
· Identify the practice problem as the focus of your Discussion post. You may use the same practice problem from earlier weeks or a different one.
· Review the chapter on practice questions in the Dang and Dearholt text and the Week 7 Media. With guidance from the Learning Resources, cast your practice problem as a critical question.
· Search the Walden Library for 4-5 scholarly articles that address your critical question.
· View the resource for synthesizing the evidence found in week 7 learning resources. Share the component of the evidence synthesis process that resonated with you. Explain how that component is reflected in your synthesis of the evidence (articles you selected to support your practice problem and critical question).
· Analyze the articles to identify evidence that would guide quality improvement.
· Return to the stakeholders that were the audience for your Module 3 Assignment. Identify the specific quality improvement component in the evidence. Then consider how you would present it to that set of stakeholders to secure agreement and action.
With these thoughts in mind …
Post a brief explanation of your critical question. Then, synthesize the 4-5 articles you identified that address your critical question. Using the same language you would use with stakeholders, explain the critical question and the value of addressing it as a quality improvement initiative. Be specific. Cite the scholarly articles and other resources to support your post.
Abstract_for_secondary_source_article.pdf
Abstract: Unlabelled: POLICY POINTS: Many barriers hamper advocacy for health equity, im contemporary economic zeitgeist, the biomedical health perspective, and difficulties across policy sectors on the issue. Effective advocacy should include persistent effo awareness and understanding of the social determinants of health. Education on the determinants as part of medical training should be encouraged, including profession within disadvantaged communities. Advocacy organizations have a central role in ac health equity g iven the challenges bridging the worlds of civil society, research, and Context: Health inequalities are systematic differences in health among social grou1 caused by unequal exposure to-and distributions of-the social determinants of healtt are persistent between and within countries despite action to reduce them. Advocac of promoting policies that improve health equity, but the literature on how to do so ef dispersed. The aim of1nis review is to synt es1ze tlie eviaence int e acaaemic ana literature and to provide a body of knowledge for advocates to draw on to inform the Methods: This article is a systematic review of the academic literature and a fixed-IE systematic search of the gr.ay literature. After applying our inclusion criteria, we anal findings according to our predefined dimensions of advocacy for health equity. Last, sy:nthesized our findings and made a critical appraisal of the literature. Findings: The policy world is complex, and scientific evidence is unlikely to be cone making decisions. Timely qualitative, interdisciplinary, and mixed-methods research valuable in advocacy efforts. The potential impact of evidence can be increased by" as part of knowledge transfer and translation. Increased contact between researche policymakers could improve the uptake of research in policy processes. Researcher role in advocacy efforts, although health professionals and disadvantaged people, w direct contact with or experience of hardship, can be particularly persuasive in advo< Different types of advocacy messages can accompany evidence, but messages sho tailored to advocacy target. Several barriers hamper advocacy efforts. The most free in the academic literature are the current political and economic zeitgeist and relatec opinion, which tend to blame disadvantaged people for their ill health, even though t approaches to health and political short-termism also act as barriers. These barriers tackled through long-term actions to raise public awareness and understanding of th through training of health professionals in advocacy. Advocates need to take advant "windows of opportun ity," which open and close quickly, and demonstrate expertise; Conclusions: This article brings together for the first time evidence from the acader gra literature and ~rovides a building block for efforts to advocate for health eguity. regarding many of the dimensions is scant, and additional research is merited, partic concerning the applicability of findings outside the English-speaking wor1d. AdvocaC' organizations have a central role in advocating for health equity, given the challenge worlds of civil society, research, and policy. (© 2015 The Authors. The Milbank Quarterly published by Wiley Periodicals, Inc. on Milbank Memorial Fund.)
:foding the cooperating rts to raise ~social al training jvocating for policy. :>s that are 1 (SDH). They y is a means fectively is gray ir efforts. mgth yzed our we
:lusive in may be 'packaging" it rs and scan play a ·ho have ::acy efforts. ·Uld be 1uently cited J public >iomedical could be
1e SDH and age of and credibility. nic and the Evidence ~ularly y s bridging the
behalf of The
practiceissue.docx
1
assignment
EXPLORING EBP QUALITY IMPROVEMENT
· PRACTICE ISSUE: BIPOLAR DISORDER
· REMEMBER TO USE APA: Writing, sentence structure.
· Please insert (intext citations) citations throughout the paper.
· Clearly state the specific theory/ apply theory to practice.
Your previous paper on this practice issue
Application of Middle Range Theories to the Care of Individuals with Bipolar
Bipolar disorder, initially referred to as manic depression, is a mental health illness whereby individuals exhibit extreme mood swings, including emotional highs (mania or hypomania) and lows (depression). The condition can severely impact an individual’s daily life; however, the effects vary between individuals. The Nation Alliance of Mental Illness reported that over 10 million Americans have bipolar, accounting for 2.8% of the population (McIntyre et al., 2020).
Middle range theories play an instrumental role in nursing, improving practice and quality of life. Several middle range nursing theories can be applied to the care of individuals with bipola. The theories offer nurses a framework for understanding and addressing the complex needs of these individuals. The self-regulation model, developed by Pender, Murdaugh, And Parsons, is an effective theory. Also known as the health promotion model, the theory describes health as a state characterized by positive dynamics instead only the absence of illness (Younas & Quennell, 2019). The health promotion model aims to enhance the overall well-being of individuals, which is why it is effective in helping individuals manage bipolar. The model notes the multifaceted character of individuals as they interact with their environments to achieve health.
Pender's model is categorized into three factors: individual features and experiences, cognitions and behavior-related feelings, and behavioral consequences (Gorbani et al., 2020). According to the theory, every individual has different personal features and experiences that impact later behaviors. The set of behavior-specific knowledge and affect factors holds significant motivational value. Nursing activities can be employed to alter the variables. This model's end-point is to promote healthy behavior (Gorbani et al., 2020).
The self-regulation model stresses the significance of promoting and maintaining health. Following the model, nurses can develop strategies significant in helping individuals with bipolar manage mood swings, follow recommended medications, and adopt a healthy lifestyle supporting mood stability. According to the self-regulation model, people are more likely to embrace health-promoting behaviors when significant others direct their behavior and offer the necessary assistance and support to facilitate the behavior (Younas & Quennell, 2019). Nurses are considered significant in health care provision and can effectively promote positive and health-promoting behavior among people with bipolar disorder. Besides, another theoretical statement deduced from the self-regulation model, which provides a foundation for investigative work on health behaviors, is that families, friends, and healthcare providers are significant interpersonal influences that can either enhance or limit engagement in behaviors that promote health (Younas & Quennell, 2019). The statement implies that through proper interventions, nurses can help promote healthy behaviors among these individuals. Nurses can work closely with family members of bipolar individuals to enhance the achievement of positive outcomes.
The self-regulation model highlights the roles of self-efficacy in promoting health behaviors. Nurses can improve bipolar individuals’ self-efficacy in managing the condition by closely working with them. Enhancing self-efficacy can involve teaching the individuals how to cope with the condition, providing education about the condition, and helping individuals set realistic goals necessary in managing their mental health.
Another model that nurses can apply to bipolar care is the Chronic Care Model. The theory emphasizes the significance of individual-centered care, self-management support, and healthcare team collaboration in managing chronic conditions like bipolar (Ortiz, 2021). The model was developed by a group of researchers led by Ed Wagner. Self-management support, a component of the model, posits that nurses should empower and prepare individuals to manage their health. According to self-management support, nurses should recognize that individuals play a central role in managing their health. While treating bipolar individuals, nurses need to involve individuals in the care and tailor treatment plans to their preferences. It implies considering individual goals of individuals in managing the condition.
Besides, nurses need to employ effective self-management support approaches, including goal-setting, action planning, and follow-up. Through self-management support, nurses can provide bipolar individuals with the resources and support necessary to manage their conditions. It includes educating individuals on mood monitoring, medication management, and coping strategies. Another critical component of the Chronic Care Model is using scientific evidence to support decisions (Ortiz, 2021). While developing appropriate interventions for individuals with bipolar, nurses base their decisions on evidence-based guidelines.
References
Gorbani, F., Mahmoodi, H., Sarbakhsh, P., & Shaghaghi, A. (2020). Predictive performance of pender’s health promotion model for hypertension control in iranian individuals. Vascular health and risk management, 299-305.
McIntyre, R. S., Berk, M., Brietzke, E., Goldstein, B. I., López-Jaramillo, C., Kessing, L. V., ... & Mansur, R. B. (2020). Bipolar disorders. The Lancet, 396(10265), 1841-1856.
Ortiz, M. R. (2021). Best Practices in Individual-Centered Care: Nursing Theory Reflections. Nursing Science Quarterly, 34(3), 322-327.
Younas, A., & Quennell, S. (2019). Usefulness of nursing theory‐guided practice: An integrative review. Scandinavian journal of caring sciences, 33(3), 540-555.
EvidenceSynthesisandRecommendationForm.pdf
© 2017 The Johns Hopkins Hospital/ Johns Hopkins University School of Nursing
Synthesis Process and Recommendations Tool
Key Points:
• Evidence synthesis is best done through group discussion. All team members share
their perspectives, and the team uses critical thinking to arrive at a judgment based
on consensus during the synthesis process. The synthesis process involves both
subjective and objective reasoning by the full EBP team. Through reasoning, the
team:
▪ Reviews the quality appraisal of the individual pieces of evidence
▪ Assesses and assimilates consistencies in findings
▪ Evaluates the meaning and relevance of the findings
▪ Merges findings that may either enhance the team’s knowledge or
generate new insights, perspectives, and understandings
▪ Highlights inconsistencies in findings
▪ Makes recommendations based on the synthesis process
• When evidence includes multiple studies of Level I and Level II evidence, there is
a similar population or setting of interest, and there is consistency across findings,
EBP teams can have greater confidence in recommending a practice change.
However, with a majority of Level II and Level III evidence, the team should
proceed cautiously in making practice changes. In this instance,
recommendation(s) typically include completing a pilot before deciding to
implement a full-scale change.
• Generally, practice changes are not made on Level IV or Level V evidence alone.
Nonetheless, teams have a variety of options for actions that include, but are not
limited to: creating awareness campaigns, conducting informational and educational
updates, monitoring evidence sources for new information, and designing research
studies.
© 2017 The Johns Hopkins Hospital/ Johns Hopkins University School of Nursing
• The quality rating (see Appendix D) is used to appraise both individual quality of
evidence and overall quality of evidence.
© 2017 The Johns Hopkins Hospital/ Johns Hopkins University School of Nursing
Date:
EBP Question:
Article
Number
Author and Date
Evidence Type
Sample, Sample
Size, Setting
Findings That
Help Answer the EBP Question
Observable Measures
Limitations
Evidence Level,
Quality
Johns Hopkins Nursing Evidence-Based Practice
Appendix H Synthesis Process and Recommendations Tool
© 2017 The Johns Hopkins Hospital/ Johns Hopkins University School of Nursing
EBP Question:
Category (Level Type) Total Number of Sources/Level
Overall Quality Rating
Synthesis of Findings Evidence That Answers the EBP Question
Level I
▪ Experimental study ▪ Randomized controlled trial (RCT)
▪ Systematic review of RCTs with or without meta-analysis
▪ Explanatory mixed method design that includes only a Level I quaNtitative study
Level II
▪ Quasi-experimental studies
▪ Systematic review of a combination of RCTs and quasi-experimental studies, or quasi- experimental studies only, with or without meta-analysis
▪ Explanatory mixed method design that includes only a Level II quaNtitative study
Level III
▪ Nonexperimental study ▪ Systematic review of a combination of RCTs,
quasi-experimental and nonexperimental studies, or nonexperimental studies only, with or without meta- analysis
▪ QuaLitative study or meta- synthesis
▪ Exploratory, convergent, or multiphasic mixed-methods studies
▪ Explanatory mixed method design that includes only a level III QuaNtitative study
Johns Hopkins Nursing Evidence-Based Practice
Appendix H Synthesis Process and Recommendations Tool
© 2017 The Johns Hopkins Hospital/ Johns Hopkins University School of Nursing
Category (Level Type) Total Number of Sources/Level
Overall Quality Rating
Synthesis of Findings
Evidence That Answers the EBP Question
Level IV
▪ Opinions of respected authorities and/or reports of nationally recognized expert committees or consensus panels based on scientific evidence
Level V
▪ Evidence obtained from literature or integrative reviews, quality improvement, program evaluation, financial evaluation, or case reports
▪ Opinion of nationally recognized expert(s) based on experiential evidence
Johns Hopkins Nursing Evidence-Based Practice
Appendix H Synthesis Process and Recommendations Tool
© 2017 The Johns Hopkins Hospital/ Johns Hopkins University School of Nursing
Based on your synthesis, which of the following four pathways to translation represents the overall strength of the evidence?
❑Strong, compelling evidence, consistent results: Solid indication for a practice change is indicated.
❑Good and consistent evidence: Consider pilot of change or further investigation.
❑Good but conflicting evidence: No indication for practice change; consider further investigation for new evidence or develop a research study.
❑Little or no evidence: No indication for practice change; consider further investigation for new evidence, develop a research study, or discontinue project.
If you selected either the first option or the second option, continue. If not, STOP , translation is not indicated.
Recommendations based on evidence synthesis and selected translation pathway
Consider the following as you examine fit:
Are the recommendations:
▪ Compatible with the unit/departmental/organizational cultural values or norms?
▪ Consistent with unit/departmental/organizational assumptions, structures, attitudes, beliefs, and/or
practices?
▪ Consistent with the unit/departmental/organizational priorities?
Consider the following as you examine feasibility:
▪ Can we do what they did in our work environment?
▪ Are the following supports available?
• Resources
• Funding
• Approval from administration and clinical leaders
• Stakeholder support
• Is it likely that the recommendations can be implemented within the unit/department/organization?
Johns Hopkins Nursing Evidence-Based Practice
Appendix H Synthesis Process and Recommendations Tool
© 2017 The Johns Hopkins Hospital/ Johns Hopkins University School of Nursing
Directions for Use of This Form
Purpose of form
Use this form to compile the results of the individual evidence appraisal to answer the EBP question. The
pertinent findings for each level of evidence are synthesized, and a quality rating is assigned to each level.
Total number of sources per level
Record the number of sources of evidence for each level.
Overall quality rating
Summarize the overall quality of evidence for each level. Use Appendix D to rate the quality of evidence.
Synthesis of findings: evidence that answers the EBP question
• Include only findings from evidence of A or B quality.
• Include only statements that directly answer the EBP question.
• Summarize findings within each level of evidence.
• Record article number(s) from individual evidence summary in parentheses next to each statement
so that the source of the finding is easy to identify.
Develop recommendations based on evidence synthesis and the selected translation pathway
Review the synthesis of findings and determine which of the following four pathways to translation
represents the overall strength of the evidence:
• Strong, compelling evidence, consistent results: Solid indication for a practice change.
• Good and consistent evidence: Consider pilot of change or further investigation.
• Good but conflicting evidence: No indication for practice change; consider further investigation for
new evidence or develop a research study.
• Little or no evidence: No indication for practice change; consider further investigation for new
evidence, develop a research study, or discontinue the project.
Fit and feasibility
Even when evidence is strong and of high quality, it may not be appropriate to implement a change in
practice. It is crucial to examine feasibility that considers the resources available, the readiness for
change, and the balance between risk and benefit. Fit refers to the compatibility of the proposed change
with the organization’s mission, goals, objectives, and priorities. A change that does not fit within the
organizational priorities will be less likely to receive leadership and financial support, making success
difficult. Implementing processes with a low likelihood of success wastes valuable time and resources on
efforts that produce negligible benefits.
Johns Hopkins Nursing Evidence-Based Practice
Appendix H Synthesis Process and Recommendations Tool
© 2017 The Johns Hopkins Hospital/ Johns Hopkins University School of Nursing
References