PICOT QUESTION
PICO question is defined as a method or technique of formulating researchable questions, which guides nurses and clinical researchers in coming up with evidence based research nursing practices (Matzo & Sherman, 2010). The PICO question formulation allows for establishment of evidenced based and current researchable questions that comes up with effective disease diagnosis and treatment protocols. The research question format consists of “P”, which describes the Patient or the Problem being investigated, “I” represents the clinical Interventions, “C” which represents comparison of known interventions with non known Intervention, and “O” which represents nursing or clinical Outcomes (Polit &Hungler, 2005).
The PICO question in this aspect concerns end-of-life care, most specifically issues related Dyspnoea, a very common and challenging condition in palliative care characterized with skewed breathing difficulties which vary in intensity. In hospice settings, patients’ perception of fear and anxiety among family members increases their discomfort and distress during end-of-life care (Marco, Buderer, &Thum, 2006). An appropriate PICO question will help reveal the causes of distress and anxiety among the caregivers and family members and help in designing techniques that would enhance relaxation and coping mechanisms. This will ultimately result to improved patient outcomes. Thus the clinical question in “PICO format” would be: “how does training of practitioners (P) serving patients with severe dyspnoea using pharmacological inreventions (I) affect how they perceive the suffering and pain of the patients in regard to use of non pharmacological interventions (C) under end-of-life care during their practice in hospice settings (O)? (Polit &Hungler, 2005).
The PICO question will enable researchers to understand the psychological impact associated with serving hospice patients. The population of interest will include the healthcare professionals including the nurses and physicians working in the hospice. In particular, the intervention which in this case is dyspnea, a common end-of-life condition that is characterized by intense breathlessness (Polit, &Hungler, 2005), will be the variable of interest. One group (experimental group) will be involved directly in patient care by providing pharmacological interventions and be compared to a control group, which will be involved in providing end-of-life care or non pharmacological interventions. Withdrawal symptoms, signs of distress and anxiety will be the outcome of the exposure. The duration (time) will span from the time a new healthcare professional begins working at the hospice to the time the symptoms become apparent (Marco, Buderer & Thum, 2006).
The clinical interventions in this aspect relate to use of pharmacological interventions such as the use of anxiolytics, opioids, oxygen, and nebulizers. The pharmacological clinical interventions are compared to non pharmacological interventions, whose main objective is to promote patient comfort while adopting breathing exercises and pacing mechanisms which help reduce symptoms associated with dyspnoea (Polit &Hungler, 2005). Unlike the pharmacological interventions, this type of care is only provided to minimize the breathing difficulties and as well reduce the severity of signs and symptoms realizable on the patient. Another comparison relates to the fact that non pharmacological means are only palliative and curative in nature and are meant to improve patients’ quality of life (Marco, Buderer & Thum, 2006).
A better patient outcome involving pharmacological interventions compared to the non pharmacological interventions will imply that the intervention is effective and should be implemented for all patients. However, if there is no significant difference between the two groups, the use of medications will be a viable intervention (Matzo & Sherman, 2010).
References
Marco, C.A., Buderer, N., &Thum, D. (2006). End of Life Care: Perspectives of Families of
Deceased Patients.American Journal of Hospice Care 22, 26‐31
Matzo, M.L. & Sherman, D.W. (2010). Palliative Care Nursing: Quality Care to the End of Life.
3rd ed. New York: Springer
Polit, D.F. &Hungler, B.P. (2005).Nursing Research: Principles and Methods. Philadelphia:
Lippincott Williams and Wilkins Publishers
