Assignment: Research PICOT Statement Draft

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Patient engagement, which involves actions that people take for their health and benefit from care, plays an instrumental role in improving health outcomes. Through patient portals, patients can closely engage their health care providers through secure messaging and other means of interaction. Patients can also access educational materials and advice, enabling them to manage their illnesses better. However, many challenges hamper the use of patient portals among adults. Issues to do with experience, convenience, and perceived benefits are common hindrances. This paper is a critical appraisal of qualitative research studies exploring the use of patient portals in health care settings.

Background of Study

Patient portals are perceived as a critical segment of the care ecosystem that patients and care providers use for individual and collaborative activities. The article by Sieck et al. (2018) provides qualitative research on the connection between patients’ experience, perception, and use of patient portals. This study is centered on the premise that experience affects perception, which further determines how adult patients use patient portals. Accordingly, the use of patient portals can be maximized if factors that motivate users can be known. Overall, the study examined perspectives on patient portal use for collaboration and engagement among experienced users. The research question was about elements that motivate patients to use patient portals to manage care and improve relationships with providers.

Portz et al. (2019) also explored the use of patient portals in health care settings qualitatively. In this study, patient portals are described as vital digital tools that enable older adults with multiple chronic conditions to engage in health management. Unfortunately, as the research problem, barriers to portal adoption among older adults are widespread and hamper effective use. User interface and experience are common barriers that should be addressed in nursing practice to improve portal adoption. The study used the Technology Acceptance Model (TAM) to qualitatively describe user interface, experience, and behaviors among older patients with multiple chronic conditions. The research question was whether patient portals’ user experience affects their use among elderly patients with chronic illnesses.

How the Articles Support the Nurse Practice Issue

The two articles will help answer my PICOT question by explaining the areas that patient education should address to improve patient portal use among adults with diabetes. Sieck et al. (2018) noted that experience improves portals use, and portals are better used for collaboration and engagement when users are motivated to use them. By showing how user experience and user interface can be improved, Portz et al. (2019) show how to better engage older adults by addressing barriers to portal adoption. In this case, the articles describe what should be done to encourage patients to use patient portals, which forms the foundation of patient education.

Concerning interventions and comparison groups, the studies use different approaches and research elements to evaluate the differences between the intervention and control groups, if any. In the study by Sieck et al. (2018), the intervention group was composed of patients with experience in using MyChart as the patient-provider engagement tool. In the study by Portz et al. (2019), the study group included patients over 65 years with multiple chronic conditions using MY Health Manager for the patient-provider experience. These intervention groups share, to a huge extent, similar characteristics with the group identified in the PICOT question. My group of interest is adults with diabetes not maximizing patient portals’ use, whose limiting factors have been explored in the two articles.

Method of Study

Despite being qualitative, the studies differ in data collection approaches. Portz et al. (2019) primarily relied on focus groups (semi-structured), while Sieck et al. (2018) used semi-structured interviews. In a focus group, a skilled moderator facilitates a discussion with the selected group of participants. Semi-structured interviews are characterized by the researcher asking more open-ended questions to the participants instead of following a strictly formalized list of questions. One of the main benefits of focus groups is that the researcher can clarify pre-conceived notions. However, opinions can be biased since participants may not provide honest and personal views about the issue of interest. On the other hand, semi-structured interviews provide more in-depth information through open-ended responses. However, the method is time-consuming since a significant number of participants must be interviewed to enable the researcher to draw valid conclusions and make comparisons.

Results of Study

Portz et al. (2019) found that portal users had favorite sections depending on the intended use, with the email, pharmacy, and lab sections of the portal being the commonly used sections. Despite patients’ commitment to using portals, challenges to log-ins user interface design, and some portals’ specific features were identified as common hindrances to effective portal use for patient-provider engagement and health knowledge. In this study, participants indicated that they perceived patient portals positively since they improved patient-provider communication, saved time and money, and were highly reliable in providing health information relevant to their health issues.

Sieck et al. (2018) focused on perspectives on portal use. In this study, logistical and psychological benefits were identified as the main reasons for patient portals’ use among experienced users. On logistical benefits, Sieck et al. (2018) found that portals’ features such as enabling patients to track their health information, communication, and better communication motivated them to use portals. Psychological benefits included a greater sense of collaboration in care and enhanced engagement of health care services. As a result, patients must perceive portals positively, implying that benefits related to using should be clear and ease of use guaranteed.

The two studies have huge implications in nursing practice. The current nursing practice is highly dependent on technology, and patients should be encouraged to use technology to enhance health outcomes. Engaging and educating patients via patient portals improve health outcomes to a huge extent. Accordingly, as Sieck et al. (2018) suggested, health care providers should improve all mechanisms that increase patient engagement in health care. In agreement with Portz et al. (2019), providers should be keen on promoting usefulness and ease of use as far as patient portals are concerned. Overall, the studies show that patient needs should be addressed to improve their engagement in health management.

Ethical Considerations

Health research should comply with the set ethical guidelines. Common ethical considerations when conducting research include informed consent and beneficence. Informed consent means that participants should participate in the research freely with full information about the implications of participating in the research. Beneficence has all to do with keeping participants free from harm. The researchers in the two articles adhere to these principles. They informed participants what it meant to engage in research and sought approval from the relevant authorizing bodies before commencing their research. Beneficence is factored in by ensuring that all participants were of sound mind and children excluded. Children are viewed as legally incompetent to provide valid consent, and including them in research can be emotionally or mentally harmful.

In conclusion, patients should be helped to improve their engagement in health management when facing challenges. Concerning adults with diabetes, they should be helped better to manage their health through patient-provider interaction via patient portals. Due to health literacy issues, experience levels, perception, portals’ configuration, among other factors, patient education is crucial to address knowledge gaps hampering patient portals’ use among older adults. The two articles show how to maximize portals’ use in adults with different illnesses.

References

Portz, J. D., Bayliss, E. A., Bull, S., Boxer, R. S., Bekelman, D. B., Gleason, K., & Czaja, S. (2019). Using the technology acceptance model to explore user experience, intent to use, and use behavior of a patient portal among older adults with multiple chronic conditions: descriptive qualitative study. Journal of Medical Internet Research, 21(4), e11604. doi: 10.2196/11604

Sieck, C. J., Hefner, J. L., & McAlearney, A. S. (2018). Improving the patient experience through patient portals: Insights from experienced portal users. Patient Experience Journal, 5(3), 47-54. doi: https://doi.org/10.35680/2372-0247.1269

Prepare this assignment as a 1,500-1,750 word paper using the instructor feedback from the Topic 1, 2, and 3 assignments and the guidelines below.

PICOT Statement

Revise the PICOT statement you wrote in the Topic 1 assignment.

The final PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Research Critiques

In the Topic 2 and Topic 3 assignments you completed a qualitative and quantitative research critique. Use the feedback you received from your instructor on these assignments to finalize the critical analysis of the study by making appropriate revisions.

The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT statement.

Refer to “Research Critique Guidelines.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.

Proposed Evidence-Based Practice Change

Discuss the link between the PICOT statement, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.

Prepare this assignment according to the APA 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 Turn-it-in. Please refer to the directions in the Student Success Center.

NRS-433V-RS-Research-Critique-Guidelines.docx

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You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.

Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.

Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.

The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.