PICO Question: Ask a research question related to nursing. Conduct a search of the literature on the problem, using the PICO(T) format. What is the quality of the literature you find on your question? How might you describe the differences between quantitative and qualitative research? What are the advantages and disadvantages of each?
Answer the following 2 questions. Examples are included. Melnyk, B.M., & Fineout-Overholt, E. (2011). Evidence-based practice in nursing and healthcare: A guide to best practice (2nd ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins. 1. Ask a research question related to nursing. Describe the problem you are addressing and why you think it is a problem. Conduct a search of the literature on the problem, using the PICO(T) format. What is the quality of the literature you find on your question? EXAMPLE: Background I work in a radiation therapy department. Skin reaction is a common and distressing side effect for patients receiving radiation therapy, particularly for women with breast cancer. Skin care companies and pharmaceutical companies often encourage the use of their products, which are often expensive to patients. I want to know if the evidence supports the use of any particular skin care regime in preventing acute skin reactions during radiation therapy. Clinical Question In patients receiving radiation therapy for breast cancer (P) does the use of a prescribed skin care regime (I), compared to allowing the patient to continue his or her usual regime (C) result in less skin reaction (O) over the course of the radiation therapy? Population: patients receiving radiation therapy for breast cancer Intervention: prescribed skin care regime Comparison: usual skin care regime Outcome: skin reaction Time: over the course of the radiation therapy Search Strategy I used the CINAHL, Medline, and Cochrane databases. Using the advanced search feature, I limited my search to studies published in the English language between the years 2000 and 2013. I typed in skin care (intervention) and radiation therapy (population) first and this produced 606 articles. I then further limited my population to breast cancer and this produced 417 articles. I used the designator “and” in order to determine the relationship between skin care and radiation therapy and breast cancer. I then applied more limiters selecting evidence-based practice and research studies. This reduced my articles to 52. I then manually reviewed the titles and/or abstracts and eliminated 27 leaving me with 25 pertinent research articles published after 2000, which is a reasonable number. Level of Evidence The analysis of level of evidence is based on the 25 relevant articles produced by this search. In these 25 articles, there were 13 randomized controlled trials (RCT), 4 systematic reviews, 1 meta-analysis, 2 case studies, 3 descriptions of development of EBP guidelines for skin care, and 2 (non-research) general clinical practice reviews. Thus the majority of these articles 18 (72%) are at the highest level of evidence. Answer to Clinical Question There is no clear answer to this question. It appears that skin reaction is dependent more on personal characteristics (obesity, diabetes, smoking) and treatment related factors (type of treatment and size of field) than on type of skin care provided. Most of the RCTs had small sample sizes. There is no evidence to support the traditional advice of avoiding creams or deodorant during radiation therapy (Bieck & Phillips, 2010; Feight, Baney, Bruce, & McQuestion, 2011). There is evidence to support both the physiological and psychological benefits of washing the involved skin (Feight et al., 2011). Women can be advised to continue their usual skin care regime as long as the skin in the treatment area is intact. Future research may need to focus on the underlying pathophysiology of skin reactions. References Bieck, T., & Phillips, S. (2010). Appraising the evidence for avoiding lotions or topical agents prior to radiation therapy. Clinical Journal of Oncology Nursing, 14, 103-105. doi:10.1188/10.CJON.103-105. Feight, D., Baney, T., Bruce, S., & McQuestion, M. (2011). Putting evidence into practice: Evidence based interventions for radiation dermatitits. Clinical Journal of Oncology Nursing, 15, 481-492. doi: 10.1188/11.CJON.481-492. 2. How might you describe the differences between quantitative and qualitative research? What are the advantages and disadvantages of each? Example from the discussion This discussion thread asks you to compare and contrast quantitative and qualitative research. An article by Crowe and Sheppard (2010) argue that these designs are more similar than different and that what is important is how to best answer the research question. Grace (2011) contends that quantitative research answers “what” questions and qualitative research can answer “why” and “how” questions. She further states that: “attention to both kinds of questions is the core of holistic nursing practice (Grace, 2011, p.91).”. What are your thoughts? Qualitative research traditionally falls low on the hierarchy of evidence. Do you feel this is warranted? Why or why not? I look forward to your thoughts on qualitative and quantitative designs.
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