NURS FPX 9902 Assessment 5 Reflection

Name

Capella University

NURS-FPX 9902 Nursing Doctoral Project 2

Prof. Name

Date

Reflection

As I near the conclusion of this course, I find it essential to reflect on the progress I have made in my doctoral project and the experiences I have accumulated during this time. Reflection is a powerful tool that allows for the evaluation of accomplishments, encounters with challenges, and the identification of potential areas for improvement. This process enhances critical thinking and problem-solving skills, providing valuable insights into both the development of the project and my personal growth as a researcher. This virtual check-in allows me to explore these reflections in greater depth, facilitating discussions regarding my progress, clarifying my work, and creating strategies for ongoing development.

Improvement Opportunities Related to Literature Synthesis

In considering the development of a literature synthesis for the PICOT question centered on interventions for COPD, I recognize the importance of a detailed and systematic literature search strategy. Conducting an extensive search utilizing relevant keywords and MeSH terms has enabled me to access a wide variety of sources, including published research, systematic reviews, and official reports. Additionally, performing manual searches of reference lists has ensured that no significant studies were omitted (Golder et al., 2019). The screening process, based on predetermined inclusion and exclusion criteria, refined the initial pool of articles, ultimately resulting in a final selection of 33 articles that met the eligibility criteria. These articles encompass various study designs, contributing to a solid and representative body of evidence that addresses the research question effectively (Costal et al., 2021).

NURS FPX 9902 Assessment 5 Reflection

Throughout the literature synthesis process, I encountered both successes and challenges. Notable successes included identifying key themes and trends within the selected articles, recognizing knowledge gaps, and determining potential areas for future research. A thorough analysis of each piece of evidence highlighted the positive effects of telehealth interventions on the health outcomes of COPD patients. However, challenges also arose, such as limited sample sizes and methodological issues in some studies, which required careful consideration during the evidence analysis and interpretation.

Furthermore, the substantial volume of information collected necessitated careful organization and synthesis to maintain a coherent and comprehensive review (Riccio et al., 2020). Moving forward, there are several areas for improvement in the literature synthesis. These include enhancing critical appraisal skills for assessing the quality and strength of evidence, conducting thorough evaluations to identify biases and limitations, incorporating additional sources like gray literature and non-English publications for a more well-rounded understanding, and ensuring that the organization and synthesis of information are carefully managed to maintain coherence and comprehensiveness. Strengthening critical appraisal skills will facilitate a more thorough evaluation of evidence quality, while including diverse sources may offer a broader perspective on the topic (Messerschmidt et al., 2022).

Support of Project and Practice Decisions

Literature review plays a critical role in informing project and practice decisions. By conducting a comprehensive literature review, researchers and healthcare professionals gain access to a wealth of existing knowledge and evidence. This process aids in understanding the current research landscape, identifying knowledge gaps, and building upon the existing evidence base (Li et al., 2019).

Insights gained from the literature review guide project decisions, including the selection of suitable interventions and the design of research studies, ensuring alignment with the best available evidence. Furthermore, the literature review provides valuable insights into clinical practice decisions, illuminating effective interventions, potential adverse effects, and areas requiring further investigation. This empowers healthcare professionals to make informed choices, improve patient outcomes, and bridge the gap between research and practice (Brice & Almond, 2020).

NURS FPX 9902 Assessment 5 Reflection

In my project focused on literature search and synthesis, the literature review was essential in guiding and shaping the entire process. A thorough literature review provided access to a wealth of existing knowledge related to COPD interventions. This review helped clarify the current state of research, pinpoint knowledge gaps, and identify potential areas for future inquiry.

Insights from the literature review not only informed the selection of relevant articles but also aided in establishing inclusion and exclusion criteria for the screening process. Additionally, the review offered a deeper understanding of key themes, trends, and the impact of nutritional and telehealth interventions on lung function and readmission rates within a specified timeframe. It also helped recognize potential limitations and methodological considerations within the studies, facilitating critical analysis and interpretation of the evidence.

Improvement Opportunities Related to Collaboration

Reflecting on collaboration and other relevant work at the project site, I have experienced a vibrant and engaging environment that has greatly contributed to the progress of my doctoral project. Working with fellow researchers, healthcare professionals, and stakeholders has proven beneficial in broadening perspectives and refining ideas. Regular meetings, discussions, and feedback sessions have yielded valuable insights, including effective search strategies, manual reference list searches, and awareness of potential challenges associated with limited sample sizes and methodological issues.

These insights have enhanced my critical appraisal skills and shaped my approach to the literature search and synthesis process. Moreover, the constructive criticism I received and the collective expertise of the team fostered creativity, innovation, and a shared sense of purpose, ultimately improving the quality of my project.

NURS FPX 9902 Assessment 5 Reflection

The outcomes of collaboration at the project site have been significant and tangible. Collaborating with experienced professionals in the field has granted me access to knowledge, resources, and practical expertise, enriching my understanding of the subject matter and allowing me to apply theoretical concepts to real-world scenarios. Contributions from collaborators have played a vital role in shaping my project’s direction, refining research questions, and identifying potential implications for practice. With their support and guidance, I have navigated challenges, overcome obstacles, and made meaningful progress in my doctoral journey (van Leeuwen & Janssen, 2019).

As with any collaborative effort, there are always opportunities for improvement. Enhancing interdisciplinary collaboration is one area that could benefit from further attention. Actively seeking input from professionals in various fields and engaging in cross-disciplinary discussions can provide a broader perspective and incorporate diverse insights into my project. Additionally, improving communication channels and ensuring efficient information sharing within the team could lead to smoother coordination and increased productivity (Gallagher & Savage, 2020).

Preconceptions, Assumptions, Biases

One’s preconceptions, assumptions, and biases can significantly impact their approach to work. These underlying beliefs and perspectives, often shaped by personal experiences, cultural influences, or societal norms, shape the lens through which individuals perceive information and interpret data. While these preconceptions can provide a valuable starting point and guide initial thinking, they may inadvertently introduce biases and limit the consideration of alternative viewpoints or new ideas (Matos et al., 2023).

Being aware of these preconceptions and actively challenging them is crucial for maintaining an open and unbiased approach. By critically examining assumptions and seeking diverse perspectives, one can expand understanding, uncover hidden biases, and cultivate a more inclusive and comprehensive approach to their work. Recognizing and mitigating the influence of biases allows for more objective, evidence-based decision-making, leading to stronger outcomes and advancements in the field (Hernández-Sellés et al., 2019).

Support from Scholarly and Authoritative Sources

Incorporating support from scholarly and authoritative sources is essential for bolstering claims and informing decision-making in COPD management. Research has shown that nutritional and telehealth interventions significantly improve lung function and reduce readmission rates in COPD patients within a 2 to 3-month period (Jiang et al., 2023). For example, a systematic review by Fan and Zhao (2021) revealed that telehealth interventions yielded promising results in managing COPD and lowering hospital readmissions. Additionally, Niranjan et al. (2022) highlighted the positive effects of nutritional interventions on enhancing lung function and overall well-being in COPD patients.

Authoritative sources, including clinical guidelines, also provide crucial guidance for COPD management. For instance, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines recommend incorporating nutritional interventions and telehealth strategies into comprehensive COPD care (Vila et al., 2023). Moreover, Furulund et al. (2021) found that nutritional interventions significantly improved lung function in COPD patients, reinforcing their effectiveness. Cristina et al. (2023) also demonstrated the positive impact of telehealth interventions on reducing readmission rates in COPD patients.

Furthermore, a recent study by Koh et al. (2023) indicated the long-term benefits of telehealth interventions in improving patient outcomes and reducing healthcare utilization among individuals with COPD. These guidelines serve as reputable sources of evidence-based recommendations and support the implementation of these interventions in clinical practice. By integrating citations from scholarly articles and authoritative guidelines, one can enhance the validity of claims and decisions regarding the efficacy of nutritional and telehealth interventions in improving lung function and reducing readmission rates in COPD patients. These sources contribute to the overall credibility and validity of the project.

Evaluation of Relevance

Assessing the relevance of sources to the claims and decisions they support is essential for ensuring the validity and reliability of the information utilized. One effective method for evaluating relevance is applying the CRAAP and RADAR tests. The CRAAP test evaluates a source’s currency, relevance, authority, accuracy, and purpose, while the RADAR test emphasizes the information’s relevancy, appearance, date, authority, and reason (Sye & Thompson, 2023). By considering these factors, one can ascertain the suitability of a source for substantiating specific claims and decisions related to COPD.

For instance, scholarly articles published in reputable, peer-reviewed journals undergo rigorous review processes, ensuring their authority and accuracy. Clinical guidelines endorsed by expert panels and professional organizations carry significant weight and relevance in guiding decision-making. By diligently applying these tests, one can select sources that align with specific claims and decisions, ensuring that the information used is current, accurate, reliable, and applicable to the project at hand (Sye & Thompson, 2023).

Conclusion

Conducting a comprehensive literature search is crucial for addressing research questions and making informed decisions. By employing a systematic approach and utilizing relevant databases, researchers can gather a wide range of

evidence to support their claims. Evaluating the relevance and quality of sources through tests such as CRAAP and RADAR ensures the reliability and validity of the information used. Reflecting on the literature search process allows for identifying successes, challenges, and opportunities for improvement, ultimately enhancing the overall quality of the research project.

References Brice, J., & Almond, M. (2020). Clinical Practice and Guidance in COPD Management. Journal of Clinical Practice, 76(2), 123-135.

Costa, D. D., Silva, F. M., & Gomes, E. (2021). Inclusion and Exclusion Criteria for Literature Reviews: Definitions and Procedures. Revista de Enfermagem, 34(1), e20190123.

Cristina, S. T., et al. (2023). Telehealth Interventions in COPD: Impact on Readmission Rates. International Journal of Respiratory Medicine, 39(3), 176-184.

Fan, S. G., & Zhao, Y. (2021). The Effectiveness of Telehealth Interventions in COPD Management: A Systematic Review. Journal of Telemedicine and Telecare, 27(5), 254-268.

Furulund, J., et al. (2021). Nutritional Interventions for Lung Function Improvement in COPD Patients. Journal of Nutrition and Health, 55(4), 321-331.

Gallagher, S., & Savage, T. (2020). Enhancing Team Collaboration in Healthcare. Journal of Healthcare Leadership, 9, 47-55.

Golder, S., Loke, Y. K., & McIntosh, H. M. (2019). Manual Searches for Identifying Studies: a Systematic Review. Systematic Reviews, 8, 191.

Hernández-Sellés, N., Muñoz-Carril, P. C., & González-Sanmamed, M. (2019). The role of social interaction in e-learning: A systematic review of the literature. Computers & Education, 130, 69-86.

NURS FPX 9902 Assessment 5 Reflection

Jiang, Y., et al. (2023). The Impact of Telehealth Interventions on COPD Outcomes: A Meta-Analysis. Respiratory Medicine, 196, 106826.

Koh, W. C., et al. (2023). Long-Term Benefits of Telehealth Interventions in COPD Management. Journal of Telemedicine and Telecare, 29(2), 102-112.

Li, J., et al. (2019). Literature Review as a Foundation for Research. Journal of Information Technology Research, 12(4), 52-65.

Matos, A. P., et al. (2023). Addressing Bias in Medical Research: A Review of Key Considerations. Journal of Medical Ethics, 49(2), 89-97.

Messerschmidt, H., et al. (2022). Evaluating Gray Literature in Healthcare Research. Journal of Health Services Research & Policy, 27(1), 49-56.

Niranjan, G. P., et al. (2022). Nutritional Interventions and COPD: Enhancing Lung Function and Well-being. Journal of Pulmonary Medicine, 45(6), 783-792.

Riccio, A., et al. (2020). Literature Screening and Evidence Synthesis: Best Practices. Systematic Reviews Journal, 9, 288.

Sye, A., & Thompson, K. (2023). Evaluating Source Relevance: The CRAAP and RADAR Tests. Information Literacy Journal, 15(1), 25-36.

van Leeuwen, C. M., & Janssen, P. J. (2019). Interdisciplinary Collaboration in Healthcare: Benefits and Challenges. Journal of Multidisciplinary Healthcare, 12, 15-24.

NURS FPX 9902 Assessment 4

Name

Capella University

NURS-FPX 9902 Nursing Doctoral Project 2

Prof. Name

Date

NURS FPX 9902 Assessment 3 Literature Synthesis

Name

Capella University

NURS-FPX 9902 Nursing Doctoral Project 2

Prof. Name

Date

Literature Synthesis

This assessment provides insights into the doctoral student’s search strategy and the methods employed for literature synthesis. The objective is for the doctoral learner to synthesize the literature gathered during the research process. This assessment will detail the comprehensive approach taken to locate literature sources, describe how these sources interrelate, and highlight commonalities and differences in research questions, methodologies, and findings.

Search Strategy

A well-developed literature search strategy is crucial for the success of a doctoral project. The references gathered during this process provide evidence-based support to define patient problems and facilitate quality improvements. The literature search commenced after identifying a patient-related issue at the project site and formulating a PICOT question: For caregivers of patients with chronic obstructive pulmonary disease (COPD), how does the implementation of COPD disease education using the teach-back method compared to current practices affect 30-day medication adherence and hospital readmission over 10 weeks? This PICOT question, along with the quality improvement project, was approved by the project site and Capella’s Institutional Review Board (IRB).

The search involved four databases accessed through Capella’s library search engine: the Cumulative Index of Nursing and Allied Health (CINAHL), Nursing and Allied Health, PubMed, and the Capella Library. The initial search began with the term “COPD readmission,” which yielded over 1,500 articles. To refine the results, only peer-reviewed articles published within the last five years were selected. Ultimately, fifteen articles met the search criteria after further exploration into the teach-back method and medication adherence.

Table 1: Literature Search Strategy Overview

The first database searched was CINAHL. The term “COPD readmission” returned 355 results. After filtering for peer-reviewed articles from the last five years, the results narrowed down to sixty-four. Not all results pertained to the PICOT question; thus, five relevant literature sources focused on COPD readmission and strategies to enhance patient outcomes were retained.

Next, the Nursing and Allied Health database was searched for “COPD Readmissions,” resulting in 1,228 articles before applying filters. After filtering, 1,194 scholarly articles remained. Three articles were selected to support the evidence-based quality improvement project, complemented by four additional qualifying references and three websites for guideline support, establishing national and global backing for the patient issue.

A separate search in the same database for the “teach-back method” generated 4,852 results, which were reduced to 4,728 after applying the same filters. Four articles were utilized to support the project, which were critical in addressing the PICOT question.

NURS FPX 9902 Assessment 3 Literature Synthesis

The subsequent database searched was PubMed, which focuses on medical science. The search for the “teach-back method” resulted in 58,327 articles, with eight articles selected that supported the application of the teach-back method for discharging COPD patients. The Capella Library was accessed last, yielding 4,128 articles, which narrowed down to 1,298 after filters were applied. Five articles were selected to bolster the PICOT question.

The literature search process was time-consuming, requiring careful examination of each article retrieved from all databases. Each piece of evidence was classified according to the hierarchy of evidence and documented in an evidence spreadsheet, with the strength of evidence measured using the CASP guidelines. The synthesis included three randomized control trials, six systematic reviews, three retrospective studies, two meta-analyses, two quality improvement projects, a mixed-method study, a qualitative descriptive retrospective study, a cross-sectional study, a logistic regression model, and a cohort study. The overall strength of the evidence is considered high, primarily comprising systematic reviews. Inclusion criteria stipulated that all articles must be of level one or two and in English, focusing on adult patients.

Table 2: Types of Studies Included in Literature Synthesis

The search strategy was essential for applying literature to practice. Additional search methods were employed to refine the literature. After gathering articles from the databases, each reference list of the qualifying resources was examined for additional relevant pieces. This manual search identified two additional resources within existing articles and five websites related to the search strategy, which proved beneficial, as all data included in the systematic review is peer-reviewed and carefully screened for relevance.

Synthesis of the Literature

Reducing Readmissions

Chronic obstructive pulmonary disease (COPD) is a progressive inflammatory lung disease and a leading cause of death worldwide, necessitating urgent intervention to address exacerbations (World Health Organization, 2019). The National Heart, Lung, and Blood Institute (NHLBI) initiated the Learn More Breath Better campaign to mitigate unnecessary hospitalizations and improve community health (NHLBI, n.d.-a). The NHLBI’s educational resources, including videos and publications, aim to equip healthcare workers with updated information for educating patients upon discharge.

Hospital readmissions not only pose risks to patients but also impose financial burdens on healthcare facilities. The Centers for Medicare & Medicaid Services (CMS) has recognized this issue, establishing the Hospital Readmission Reduction Program (HRRP) to incentivize hospitals to lower readmission rates (CMS, n.d.). A randomized control trial highlighted that healthcare workers must implement and instruct patients on their action plans at discharge, alongside the support of home health or transitional care (Hegelund et al., 2019). Although this trial noted gaps due to its small sample size, the findings emphasized the importance of proactive patient education.

Additionally, Zafar (2019) pointed out that chronic diseases account for 41% of healthcare spending. Hospitals are thus motivated to reduce COPD readmissions to alleviate costs associated with these chronic conditions. Various strategies have been employed to minimize COPD exacerbations and subsequent hospital admissions. These include personal action plans and structured telephonic consultations, as demonstrated by Sutton and Phelps (2021), which resulted in a 7% decrease in COPD readmissions.

NURS FPX 9902 Assessment 3 Literature Synthesis

However, a cohort study indicated that monitoring the respiratory rate might be more effective for predicting exacerbations (Hawthorne et al., 2022). The study found that a slight increase in respiratory rate could signal impending exacerbations. Additionally, Zafar et al. (2017) stressed the necessity of reducing early admissions to maintain high-performing healthcare delivery. Conversely, Zhong et al. (2019) attempted to utilize predictive modeling with incentivized metrics to identify patients at high risk of readmission, suggesting that combining continuous monitoring with self-care education can enhance patient outcomes.

The HRRP program, established by CMS, has imposed accountability for readmissions on hospitals, leading to the development of quality improvement metrics aimed at reducing these occurrences. A retrospective cohort study conducted from 2010 to 2016 found that, following the introduction of the HRRP, COPD readmission rates decreased from 19% to 17% (Buhr et al., 2020). However, the study did not specify particular hospital sites or the sample population. Despite the complexity of predicting exacerbations, all studies agree on the necessity for hospitals to address this challenge and implement effective quality improvement initiatives.

Self-Care

Risk factors for COPD vary among patients, making it vital to understand and mitigate these risks. Smoking remains the most significant risk factor associated with the disease (Hu et al., 2022). Environmental factors, including those related to rural farming or urban air quality, also contribute to COPD development (Hu et al., 2022). Challenges faced by COPD patients include adherence issues, socioeconomic status, low health literacy, and psychological concerns (Zhong et al., 2019). Recognizing these challenges, the NHLBI aims to assist patients in understanding their condition and promoting self-management to reduce readmissions at the practicum site.

Chronic disease management often fluctuates based on a patient’s symptoms and severity. Primary care clinicians play a crucial role in care management and non-emergency healthcare. They have developed clinical guidelines for managing patients with controlled COPD, routinely offering preventive services, including smoking cessation counseling and immunizations (Stevermer et al., 2021). This aligns with Hu et al.’s (2022) call for screening patients for socioeconomic factors.

Furthermore, Pahus et al. (2019) recommend screening for high-risk factors, such as smoking and comorbidities like congestive heart failure and diabetes, which influence COPD phenotypes. However, their study faced enrollment challenges due to differing eligibility criteria from established practice guidelines (Stevermer et al., 2021). The goal of COPD care should focus on reducing exacerbation opportunities through education and effective disease management.

Proper patient education is crucial for alleviating the financial burden of high healthcare costs and poor outcomes. A meta-analysis by Allegrante et al. (2019) suggests that the teach-back method significantly improves patients’ understanding of health conditions and care plans. The teach-back method encourages patients to demonstrate their understanding of information presented to them. This approach enhances health literacy and leads to better disease management, ultimately improving adherence to treatment plans.

Implementation of the Teach-Back Method

The implementation of the teach-back method, focusing on patient-centered education, has shown promise in improving health outcomes. A systematic review by Hegelund et al. (2019) indicates that patient activation strategies are effective in enhancing patient engagement and reducing readmission rates. This method has gained recognition in various healthcare settings, emphasizing the need for individualized patient education.

Furthermore, a quality improvement study by Santos et al. (2020) highlights the positive impact of incorporating the teach-back method in chronic disease management. The study demonstrated that patients who received education using this technique were more likely to adhere to their medication regimen and report better understanding of their condition. By fostering an environment of open communication and active participation, the teach-back method empowers patients to take control of their health.

Conclusion

The synthesis of the literature underscores the critical importance of implementing evidence-based strategies in chronic disease management. The gathered literature emphasizes the significance of patient education, self-care strategies, and the implementation of the teach-back method. With the ongoing challenges of managing COPD, healthcare professionals must adopt innovative approaches to enhance patient understanding and engagement.

The implementation of the teach-back method and other evidence-based practices can significantly contribute to improving health outcomes, reducing readmission rates, and ultimately enhancing the quality of care provided to COPD patients. As healthcare continues to evolve, it is imperative to prioritize patient-centered approaches that empower individuals to actively participate in their health management.

References

Allegrante, J. P., Barlow, J., & Kaplan, G. (2019). Patient activation and adherence in chronic disease management: A systematic review. Patient Education and Counseling, 102(8), 1384-1390.

Buhr, G. T., Bartholomew, A. A., & Jacobs, J. (2020). Impact of the Hospital Readmission Reduction Program on COPD readmission rates. Journal of Healthcare Management, 65(5), 325-332.

CMS. (n.d.). Hospital Readmission Reduction Program. Retrieved from CMS website

Hegelund, A., Damsgaard, M. T., & Moller, D. (2019). Patient activation and adherence in chronic disease management: A systematic review. BMC Health Services Research, 19(1), 400.

Hu, D., Liu, X., & Qian, J. (2022). Environmental and socioeconomic factors influencing the risk of COPD in patients. International Journal of Chronic Obstructive Pulmonary Disease, 17, 1225-1234.

NHLBI. (n.d.-a). Learn More Breathe Better campaign. Retrieved from NHLBI website

Pahus, D., Tjalma, R., & Pedersen, S. H. (2019). Screening for risk factors in COPD patients: A cross-sectional study. Respiratory Medicine, 153, 1-8.

NURS FPX 9902 Assessment 3 Literature Synthesis

Santos, R., Tomaz, L., & Souza, E. (2020). Impact of the teach-back method on medication adherence in patients with chronic diseases. International Journal of Nursing Studies, 107, 103-111.

Stevermer, J. J., Boker, J., & Zink, T. (2021). Managing chronic obstructive pulmonary disease in primary care: Clinical guidelines and patient education. American Family Physician, 103(4), 245-254.

Sutton, L., & Phelps, C. (2021). Telephonic consultations and COPD readmission rates: A quality improvement initiative. Nursing Practice, 54(7), 45-50.

World Health Organization. (2019). Global action plan for the prevention and control of noncommunicable diseases 2013-2020. Retrieved from WHO website

Zafar, A. (2019). Financial burden of chronic diseases on healthcare systems. Health Affairs, 38(2), 285-293.

Zafar, A., Smith, R., & Johnson, L. (2017). Reducing early admissions in chronic obstructive pulmonary disease patients: A comprehensive approach. Journal of Clinical Medicine, 6(1), 7.

Zhong, Y., Li, T., & Chen, M. (2019). Predictive modeling for readmissions in COPD patients: An innovative approach. BMC Pulmonary Medicine, 19(1), 54.

NURS FPX 9902 Assessment 2 Literature Search

Name

Capella University

NURS-FPX 9902 Nursing Doctoral Project 2

Prof. Name

Date

Literature Search

The approach for conducting the literature search for this project, which aims to provide individualized cognitive behavioral therapy (CBT) lessons and motivational questioning for patients struggling with opioid addiction, includes several key components. A thorough search will be performed across multiple databases, specifically PubMed, CINAHL, PsycINFO, and the Cochrane Library.

The terminology pertinent to the PICOT question will encompass opioid addiction, cognitive behavioral therapy, motivational interviewing, client-centered treatment, and readmission rates. In order to efficiently locate relevant articles, Boolean search operators such as “AND” and “OR” will be utilized, along with filters for publication year and article type, particularly focusing on peer-reviewed studies (Hah et al., 2020). The primary goal of the literature search is to identify the most pertinent and scientifically valid studies that examine the effectiveness of the proposed interventions in reducing readmission rates within the target population.

Literature Search Strategy

A variety of search strategies will be implemented to gather the necessary literature for the project concerning individualized CBT sessions and motivational interviewing for patients with opioid addiction. The selected databases are crucial for this endeavor. Search terms may include opioid addiction, cognitive behavioral therapy, motivational interviewing, individualized treatment, and readmission rates, along with other relevant keywords. Medical Subject Headings (MeSH) terms such as Opioid-Related Disorders, Cognitive Behavioral Therapy, and Motivational Interviewing will be employed to refine the search to articles most relevant to the study.

To further narrow the search results, Boolean operators like “AND” and “OR” will be applied, along with filters for publication date and peer-reviewed status. MacLean et al. (2024) emphasize the importance of additionally manually reviewing the reference lists of the included studies and systematic reviews to uncover other related literature. This approach will ensure that only the most recent information is included, sourcing materials from the last five years. All prior sources deemed significant, influential, and related to the project will be integrated into the review.

The initial search is anticipated to yield numerous potential sources. The inclusion criteria will focus on studies involving adult substance abusers that utilize individualized CBT and motivational interviewing, while outcomes such as readmission rates will be assessed. Articles not published in English, studies involving children, or those lacking robust scientific quality will be excluded from consideration.

In addition to peer-reviewed articles, the search strategy will encompass systematic reviews, government reports, and, if necessary, dissertations and thesis reports, collectively referred to as “gray literature” (DeBar et al., 2021). Ultimately, 20 to 30 high-quality and relevant sources will be retained for the literature summary, following the application of inclusion and exclusion criteria. These sources will be analyzed and compiled to provide valuable information that will inform the planning, implementation, and evaluation of the project, ensuring that the methodology is based on the most accurate and up-to-date information available.

Analysis of Evidence

The analysis revealed that 20 peer-reviewed articles were utilized in this study. These articles were selected for their relevance to the PICOT question and their strong methodological quality. The studies employed various research designs, including randomized controlled trials, systematic reviews, and qualitative analyses.

The research primarily focused on identifying key outcomes and trends while evaluating the quality and robustness of the evidence. Based on these 20 articles, it can be inferred that there is substantial knowledge regarding the efficacy of CBT and motivational interviewing in addressing substance use disorders and chronic pain management. Thus, the current findings support several conclusions and allow for recommendations regarding practice and future research directions.

Organization of Literature

From the literature reviewed in relation to the PICOT question, several themes emerged. Firstly, research by DeBar et al. (2021), Gazzola et al. (2022), and Lent et al. (2021) indicates that both CBT and motivational interviewing are effective interventions for individuals experiencing opioid addiction or chronic pain. Additionally, studies have demonstrated the effectiveness of these therapies in managing pain, mental health, and substance use issues (Amin et al., 2023; Zamboni et al., 2021).

Secondly, the findings suggest that careful consideration should be given to the modality of these interventions and their associated costs within various healthcare settings, including primary care, hospital, and specialist care (MacLean et al., 2024; Olmstead et al., 2020; Zerden et al., 2020). Thus, the cost implications of implementing CBT should not be overlooked in organizational planning.

Finally, anxiety and depression are the most commonly studied co-occurring issues. Thirdly, both CBT and motivational interviewing appear to be effective in treating individuals with opioid use disorder who also present with psychiatric disorders such as depression and anxiety (Buckner et al., 2023; McHugh et al., 2024). However, notable knowledge gaps remain regarding the long-term effects of these treatments and the potential differences in outcomes across diverse demographic groups or conditions.

Conclusion

The selected 20 articles, characterized by their relevance and methodological rigor, have unveiled several prominent trends. The research highlights the necessity of considering both the administration of these interventions and their cost-effectiveness within various hospital environments.

Literature Search and Analysis Table

References

Amin, M., Reza Davasaz Irani, Fattahi, P., & Sirus Pakseresht. (2023). Effects of brief cognitive behavioral therapy on mental health in substance-related disorder: A randomized controlled trial. BMC Psychiatry, 23(1).https://doi.org/10.1186/s12888-023-05413-4

Bertholet, N., Meli, S., Palfai, T. P., Cheng, D. M., Alford, D. P., Bernstein, J., Samet, J. H., Lloyd-Travaglini, C., & Saitz, R. (2020). Screening and brief intervention for lower-risk drug use in primary care: A pilot randomized trial. Drug and Alcohol Dependence, 213, 108001.ttps://doi.org/10.1016/j.drugalcdep.2020.108001

Borsari, B., Li, Y., Tighe, J., Manuel, J. K., Gökbayrak, N. S., Delucchi, K., Morasco, B. J., Abadjian, L., Cohen, B. E., Baxley, C., & Seal, K. H. (2021). A pilot trial of collaborative care with motivational interviewing to reduce opioid risk and improve chronic pain management. Addiction, 116(9).https://doi.org/10.1111/add.15401

Buckner, J. D., Scherzer, C. R., Crapanzano, K. A., & Morris, P. E. (2023). Group cognitive behavioral therapy for substance use disorders among psychiatric inpatients in a medically underserved area: An intervention for opioid misuse. Public Health Reports, 138(1_suppl), 90S95S.https://doi.org/10.1177/00333549231170219

Buckner, J. D., Walukevich-Dienst, K., Crapanzano, K. A., Tucker, R. P., & Tynes, L. L. (2021). Brief motivational interviewing–based interventions for opioid misuse in hospital settings. Translational Issues in Psychological Science, 7(2), 114–129.https://doi.org/10.1037/tps0000280

NURS FPX 9902 Assessment 2 Literature Search

Darnall, B. D., Mackey, S. C., Lorig, K., Kao, M.-C., Mardian, A., Stieg, R., Porter, J., DeBruyne, K., Murphy, J., Perez, L., Okvat, H., Tian, L., Flood, P., McGovern, M., Colloca, L., King, H., Van Dorsten, B., Pun, T., & Cheung, M. (2019). Comparative effectiveness of cognitive behavioral therapy for chronic pain and chronic pain self-management within the context of voluntary patient-centered prescription opioid tapering: The EMPOWER study protocol. Pain Medicine, 21(8).https://doi.org/10.1093/pm/pnz285

DeBar, L., Mayhew, M., Benes, L., Bonifay, A., Deyo, R. A., Elder, C. R., Keefe, F. J., Leo, M. C., McMullen, C., Owen-Smith, A., Smith, D. H., Trinacty, C. M., & Vollmer, W. M. (2021). A primary care–based cognitive behavioral therapy intervention for long-term opioid users with chronic pain. Annals of Internal Medicine, 175(1).https://doi.org/10.7326/m21-1436

Gazzola, M. G., Beitel, M., Cutter, C. J., & Barry, D. T. (2022). Cognitive behavioral therapy for chronic pain and opioid use disorder. Elsevier EBooks, 235–246.https://doi.org/10.1016/b978-0-12-820237-1.00022-3

Hah, J. M., Trafton, J. A., Narasimhan, B., Krishnamurthy, P., Hilmoe, H., Sharifzadeh, Y., Huddleston, J. I., Amanatullah, D., Maloney, W. J., Goodman, S., Carroll, I., & Mackey, S. C. (2020). Efficacy of motivational-interviewing and guided opioid tapering support for patients undergoing orthopedic surgery (MI-Opioid Taper): A prospective, assessor-blind, randomized controlled pilot trial. EClinicalMedicine, 28.https://doi.org/10.1016/j.eclinm.2020.100596

NURS FPX 9902 Assessment 2 Literature Search

Lent, M. R., Callahan, H. R., Womer, P., Mullen, P. M., Shook, C. B., DiTomasso, R. A., Felgoise, S. H., & Festinger, D. S. (2021). A mental health professional survey of cognitive‐behavioral therapy for the treatment of opioid use disorder. Journal of Clinical Psychology, 77(7), 1607–1613.https://doi.org/10.1002/jclp.23170

MacLean, R. R., Ankawi, B., Driscoll, M. A., Gordon, M. A., Frankforter, T. L., Nich, C., Szollosy, S. K., Loya, J. M., Brito, L., Ribeiro, M. I. P., Edmond, S. N., Becker, W. C., Martino, S., Sofuoglu, M., & Heapy, A. A. (2024). Efficacy of integrating the management of pain and addiction via collaborative treatment (impact) in individuals with chronic pain and opioid use disorder: Protocol for a randomized clinical trial of a digital cognitive behavioral treatment. JMIR Research Protocols, 13(1), e54342.https://doi.org/10.2196/54342

McHugh, R. K., Fitzmaurice, G. M., Votaw, V. R., Geyer, R. B., Ragnini, K., Greenfield, S. F., & Weiss, R. D. (2024). Cognitive behavioral therapy for anxiety and opioid use disorder: Development and pilot testing. Journal of Substance Use and Addiction Treatment, 160, 209296.https://doi.org/10.1016/j.josat.2024.209296

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NURS FPX 9902 Assessment 2 Literature Search

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NURS FPX 9902 Assessment 2 Literature Search

Zgierska, A. E., Burzinski, C. A., Garland, E. L., Lennon, R. P., Jamison, R., Nakamura, Y., Barrett, B., Sehgal, N., Mirgain, S. A., Singles, J. M., Cowan, P., Woods, D., & Edwards, R. R. (2021). Mindfulness-based therapy compared to cognitive behavioral therapy for opioid-treated chronic low back pain: Protocol for a pragmatic randomized controlled trial. Contemporary Clinical Trials, 110, 106548.https://doi.org/10.1016/j.cct.2021.10654

NURS FPX 9902 Assessment 1

Name

Capella University

NURS-FPX 9902 Nursing Doctoral Project 2

Prof. Name

Date