Assignment 1: Application – PICO Analysis of Dementia, Delirium, and Depression

A PICO analysis is used to pose a focused clinical question to which you find appropriate evidence-based answers. The PICO question should include the patient or population (P), anticipated intervention (I), comparison group or current standard (C), and outcome desired (O). In this Assignment, you develop a question related to dementia, delirium, or depression. Through your PICO analysis, you explore various resources and examine current evidence to answer the question you develop.

To prepare:

• Select one of the following disorders as your topic: dementia, delirium, or depression.
• Review the guidelines in the “Literature Review Matrix” document in this week’s Learning Resources.
• Think about a research question around your issue as indicated in Part I: PICO Analysis of Research Topic.
• Consider the resources you will use, search terms and criteria, and Boolean search strings as indicated in Part II: Search Strategy.
• Using the Walden Library and other appropriate databases, locate five articles related to your PICO question. At least one article must be a systematic review. All of the articles should be primary sources.
• Reflect on the five articles you selected as indicated in Part III: Analysis of Literature. Consider the conceptual framework/theory, main finding, research method, strengths of study, weaknesses, and level of evidence for each article.
• Consider how to use the summaries in Part III to create an evidence table. Use this evidence table to determine appropriate treatment options for patients who present with the disorder you selected as your topic.

To complete:

• Formulate a question around the disorder you selected as indicated in Part I: PICO Analysis of Research Topic.
• Identify the resources you will use, search terms and criteria, and Boolean search strings as indicated in Part II: Search Strategy.
• Summarize the five articles you selected as indicated in Part III: Analysis of Literature. Describe the conceptual framework/theory, main finding, research method, strengths of study, weaknesses, and level of evidence for each article.
• Create an evidence table based on the article summaries in Part III. Describe appropriate treatment options for patients based on this evidence table.

ANSWER

Journal 6

Topic: Does effective treatment of dementia behavioral symptoms helps to relief caregivers’ burden through non-pharmacology interventions and participation in activity.

PICO analysis of the research topic

P (Problem, patient or population): Treatment of dementia behavioral symptoms 

I (Intervention): Non-pharmacology interventions

C (Comparison): Participation in activity   

O (Outcome of interest): Relief caregivers’ burden

Summary of the Articles

Moniz Cook, E., Swift, K., James, I., Malouf, R., De Vugt, M., & Verhey, F. (2012). Functional analysis-based interventions for challenging behaviour in dementia. Cochrane Database Of Systematic Reviews. doi: 10.1002/14651858.cd006929.pub2

Functional analysis is a behavior management technique and has been argued to be a promising intervention that underscores exploring the purpose and meaning of the person’s behavior (Moniz Cook et al. 2012).  For a long time, management of challenging behavior including agitation and aggression in dementia was extensively done through the help of drug therapies including the antipsychotics. Despite of the associated efficacy, potential detriments as well as side effects affect the quality of life (Moniz Cook et al. 2012). The conceptual framework used that of functional analysis as behavioral intervention approach. This article extends the ABC approach of the behavioral analysis in order to overcome restrictions associated with deriving a single explanatory hypothesis of the individual’s behavior. The research methods used was the search AlOIS with the help of randomized controlled trials (Moniz Cook et al. 2012).  The article notes that there are positive effects associated with post-intervention of the frequency of the challenging behavior reported as well as the care giver reactions. However, one weakness was noted since establishing FA real effect was not achieved. The article has a strong level of evidence.  

Xing, S., Zhu, C., Zhang, R., & An, L. (2014). Huperzine A in the Treatment of Alzheimer’s Disease and Vascular Dementia: A Meta-Analysis. Retrieved from http://dx.doi.org/10.1155/2014/363985 The principle cause of Dementia in the late life (65 years) is the vascular dementia and Alzheimer disease. The conceptual framework used is that Huperzine selectively inhibits the activities of acetyl cholinesterase and consequently helps to improve the cognitive function of the brain (Xing, Zhu, Zhang & An, 2014). Research has shown the use of this medication is devoid of any toxicity. The research method used was the…