PowerPoint Presentation: Advanced Practice

Introduction and PICOT Question Assignment

Isabella Echeverria

St. Thomas University

NUR-611-AP2

Dr. Janet M. Huxley

July 27, 2025

Introduction and PICOT Question Assignment

PICOT Question

In pediatric oncology patients (P), how does the consistent use of standardized mental health screening tools (I), compared to inconsistent or no standardized screening (C), affect the early identification and management of emotional distress (O) during a six-month treatment period (T)?

Purpose and Rationale for the Scholarly Project

This study examines the inconsistent use of standardised mental health screening instruments in paediatric oncology. Despite the limited evidence-based methods that exist to study emotions and psychology, they are not systematically or consistently used to assess them in the pediatric oncology environment. Cancer treatment of children usually does not identify the status of emotional distress in children, potentially affecting the psychological sense of a patient, and deregulating the risk of treatment adherence, physiological healing, and health in adulthood. The current project aims to assess how advanced practice nurses (APNs) can reduce this severe deficit by promoting and adopting uniform mental health screening measures.

Evidence-based appeal to this question emerges due to the widely-documented relationship between early mental health intervention and better treatment outcomes of pediatric cancer patients. Deshields et al. (2021) explain that regular psychological screening can be used to identify distress early, which results in timely intervention that contributes to patient and family resilience. Moreover, standard screenings will provide fairer care as it reduces subjective assessment bias practices. This project can facilitate not only quality holistic care but also effective resource distribution of health care by empowering APNs with effective screening tools and implementation tools. Mental health outcome improvement can lessen occurrences of delays in treatment, recurrent hospital admissions, and prolonged psychiatric treatment, offering financial returns by means of offsetting costs and enhancing the lives of patients.

Background on the Problem or Population of Interest

Children with cancer have mental challenges as well as physical ones. Up to 60% of paediatric oncology patients exhibit anxiety, despair, and post-traumatic stress, according to studies. Lee et al. (2023). Validated instruments like the Paediatric Symptom Checklist and Psychosocial Assessment Tool are rarely used. Unstandardised institutional guidelines and poor frontline provider training contribute to this variation.

Paediatric oncology advanced practice nurses are well-positioned to incorporate mental health screening into normal care. With training in holistic and family-centered care, APNs can spot psychological concerns early and refer or intervene. Bitsko et al. (2022) recommend mental health surveillance in chronic illness care as a key paediatric practice. Using systematic and structured assessment to address paediatric oncology patients' emotional well-being offers a more holistic cancer care paradigm.

Significance of the Problem to Nursing and Health Care

This issue supports healthcare goals to improve patient-centered treatment, early intervention, and health equity. The Healthy People 2030 objectives emphasise mental health and the integration of behavioural and physical health services, according to Martinelli (2024). Addressing emotional distress in cancer-stricken youngsters supports public health initiatives and reduces long-term psychiatric consequences.

Nursing emphasises holistic care and patient advocacy. Thus, inconsistent mental health screenings in paediatric oncology contradict nursing values. Nurses can change institutional policy and improve interdisciplinary collaboration by identifying this gap and presenting a systematic, evidence-based remedy. The research also shows APNs' rising role in quality improvement and care coordination, demonstrating nursing's leadership in tackling systemic health inequities. Like Chapter 2, a research question is significant when the outcomes can affect nursing theory, improve clinical recommendations, or challenge practice (Elsevier, 2018). This project's question fits all three criteria.

Benefit of the Project to Nursing Practice

This project promotes nursing in several ways. First, it outlines how paediatric oncology APNs can incorporate mental health screening into their daily work. Standardised tools and evidence-based guidelines help nurses make better clinical decisions and provide prompt psychosocial interventions. Improved emotional distress identification may lead to early intervention and better cancer treatment adherence.

Second, the project encourages APNs to lead practice innovation, promoting professional development. Systematic screening programs require clinical, teaching, advocacy, and evaluation capabilities. Advanced nursing courses and national practice standards emphasise these competencies.

Third, paediatric cardiology and endocrinology, where chronic illness impairs psychological well-being, can use the project's findings. A standardised mental health screening approach in paediatric oncology could be applied to other paediatric subspecialties.

Finally, applying clinical research to real-world challenges advances evidence-based practice. Your course materials (Chapter 2) state that PICOT-formatted clinical questions make interventions measurable and results clear. This study integrates nursing theory, clinical research, and practice to enhance patient outcomes and enrich the nursing profession.

Conclusion

Paediatric cancer has a devastating emotional and psychological impact, but many healthcare settings ignore it. Standardised mental health screening techniques are inconsistently used, hindering holistic care. This scholarly effort uses a well-constructed PICOT question to empower APNs to lead evidence-based emotional care initiatives for paediatric oncology patients. Nurses can prevent emotional distress from becoming an unseen consequence of childhood cancer via screening, early detection, and timely care. This study could transform paediatric oncology, promote interprofessional collaboration, and benefit other vulnerable paediatric populations.

References

Bitsko, R. H., Claussen, A. H., Lichstein, J., Black, L. I., Jones, S. E., Danielson, M. L., Hoenig, J. M., Davis Jack, S. P., Brody, D. J., Gyawali, S., Maenner, M. J., Warner, M., Holland, K. M., Perou, R., Crosby, A. E., Blumberg, S. J., Avenevoli, S., Kaminski, J. W., Ghandour, R. M., & Meyer, L. N. (2022). Mental Health Surveillance Among Children — United States, 2013–2019. MMWR Supplements, 71(2), 1–42. https://doi.org/10.15585/mmwr.su7102a1

Deshields, T. L., Wells‐Di Gregorio, S., Flowers, S. R., Irwin, K. E., Nipp, R., Padgett, L., & Zebrack, B. (2021). Addressing distress management challenges: Recommendations from the consensus panel of the American Psychosocial Oncology Society and the Association of Oncology Social Work. CA: A Cancer Journal for Clinicians, 71(5). https://doi.org/10.3322/caac.21672

Elsevier Inc. (2018). Chapter 2: Research Questions, Hypotheses, and Clinical Questions [PowerPoint slides]. In RESEARCH/SCIENCE APPROACHES

Lee, A. R. Y. B., Yau, C. E., Low, C. E., Li, J., Ho, R. C. M., & Ho, C. S. H. (2023). Severity and Longitudinal Course of Depression, Anxiety and Post-Traumatic Stress in Paediatric and Young Adult Cancer Patients: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine, 12(5), 1784. https://doi.org/10.3390/jcm12051784

Martinelli, A. (2024). Sustainable Promotion of Mental Health and Prevention of Mental Health Disorders Across the World. Integrated Science, 1–23. https://doi.org/10.1007/978-3-031-64288-3_1