Evidence Informed Nursing Practice

Table of Contents

Task 1: Abbreviated PICO Template.

Task-2: Justification of the resources.

Task 1: Abbreviated PICO Template

Abbreviated PICO Template and Search Strategy (see NURS11158 Unit Profile for assessment requirements)

Brief description of the problem or topic:

Perla Daniel is 78 years old and has recently moved into a low care residential facility. Perla suffers from chronic low back pain. She tells you that since she is sitting around more in her little unit, her pain has become worse. Perla states that she has previously used to take NSAIDS (Ibuprofen) and a hot pack for the pain. However, recently the anti-inflammatories have been giving her heartburn and making her feel sick. Her GP is on leave and the locum has ordered “Panadeine” and bed rest for the pain. Perla says a friend of hers started Yoga and she says it has helped her low back pain tremendously. Perla asks you whether exercise like Yoga or Tai Chi could be better for her low back pain than the “Panadeine”.

Task 1: Development of PICO - Total word count: 50 words

   

Keyword search terms

Alternative terms/synonyms

P

Population/Patient/Problem

CLBP (Chronic Low back pain)

Low back pain, LBP, prolonged LBP

I

Intervention

Yoga , Tai Chi

Alternative physical therapy, stabilisation exercise, interstitial electro stimulation

C

Control/Comparison

Ibuprofen,

Panadeine, Analgesic

O

Outcomes

Effective pain management

CLBP managment

Write your clinical/research question:

Is Yoga therapy is better than that of Tai Chi in the management of Chronic Low Back Pain CLBP?

Identify Databases Used

Cochrane Library of Systematic reviews, Medline, Pubmed, NCBI: PCM

,

,

Identify search filters or limits used

Year (not older than 2015), irrelevant drug molecules, unauthorised sources.

Table 1: PICO analysis

Task-2: Justification of The Resources

Reference: Resource 1

Gerasimov, A. A., Meshchaninov, V. N., & Shcherbakov, D. L. (2019). Mechanisms of pathogenetic treatment with interstitial electrostimulation for spinal pain syndrome. Cochrane Library of Systematic reviews. https://doi.org/10.17116/kurort20199604112

Type of Study

This is a statistical study of the implementation of interstitial electro stimulation for the therapy of low back pain. In this case, 64 patients with low back pain have been selected as samples of the experimental therapy. Unlike to the systematic review, it has not only concentrated on the secondary data for research.

Ethical Approval

Yes, the study is ethically approved as all the patients have been involved in the experimental therapy as per their own wish. All the safety measures have been taken for this pathogenetic treatment which has prevented any type of harm, mental or physical deterioration of the patients. The safety aspect has been explained to the population involved in this study.

Justification paragraph using the five components with ARCOC

The authority of this resource is highly esteemed as the initiative of this study has been taken by the health ministry of Russia. The study regarding the implementation of electro stimulation rather than Tai chi has been conducted by keeping a control group in respect of which the effectiveness of physiotherapy has been identified (Gerasimov, Meshchaninov & Shcherbakov, 2019). The study of this paper has its relevance with the context of Perla Daniel as a number of patients are adobe the age group of 70. The coverage of this study includes an alternative therapy for low back pain rather than the application of panadeine. Objectivity is to help the clinical condition of low back pain and the therapy has helped 90.5% of the selected population. In the context of currency it can be mentioned that this study has been done in 2019 which justified its relevance with current time.

Reference: Resource 2

de Campos, T. F. (2017). Low back pain and sciatica in over 16s: assessment and management NICE Guideline [NG59]. J Physiother63(2), 120. https://doi.org/10.1016/j.jphys.2017.02.012

Type of Study

This is a systematic review.

Ethical Approval

Yes, the study is ethically approved as it has followed the guideline of NICE (National Institute of Health and Care Excellence- the UK).

Justification paragraph using the five components with ARCOC

This resource has the authority to provide a trustable guideline for the therapy and treatment of the chronic patients of low back pain by replacing the old NICE-CG88 guideline for low back pain care. The study has its relevance with the provided case study of Perla Daniel as the guideline development has been done for the patients who are suffering more than 16 years with the issuer of low back pain. The implementation of physiotherapy, yoga, acupressure and psychological care is also associated with the treatment of this clinical issue.

The main coverage of the study is to provide clinical guidelines for the patients with prolonged use of the analgesic drugs like Ibuprofen or Panadeine. Objective of the study is to construct a well-defined guideline for nursing and self-care for the chronic low back pain patients. The guidelines have been constructed with a committee of 18 pain medicine experts and the paper has been published in the year 2017. This proves the currency of this resource.

Reference: Resource 3

Gomes-Neto, M., Lopes, J. M., Conceicao, C. S., Araujo, A., Brasileiro, A., Sousa, C., ... & Arcanjo, F. L. (2017). Stabilization exercise compared to general exercises or manual therapy for the management of low back pain: a systematic review and meta-analysis. Physical therapy in Sport23, 136-142. https://doi.org/10.1016/j.ptsp.2016.08.004

Type of Study

This study is a meta-analysis and systematic review about stabilisation exercise for low back pain patient

Ethical Approval

Yes, the study is ethically approved and all the ethics regarding secondary data analysis has been maintained in this paper.

Justification paragraph using the five components with ARCOC

The authority of this paper is quite reliable as the secondary data for this paper has been sourced from the databases like Cochrane, MEDLINE, Scielo. In the case study of Perla Daniel, the fact of yoga therapy for the minimization of the pain load of low back pain has been mentioned. The stabilisation exercise has much of the attributes just like yoga therapy. Hence, from this angle, the relevance of this resource can be justified. Coverage of this paper includes the analysis of effectiveness of stabilisation exercise with that of the conventional manual therapy for low back pain for the aged patients like Perla Daniel. It has been identified the patients have a tendency to consume pain relieving medicines like panadeine and in the major cases these are prescribed by the general practitioners. The objective is to replace this trend with that of alternative exercise. The paper has been published in 2017 and this indicates its currency in recent times.

Reference: Resource 4

Patil, N. J., Nagarathna, R., Tekur, P., Patil, D. N., Nagendra, H. R., & Subramanya, P. (2015). Designing, validation, and feasibility of integrated yoga therapy module for chronic low back pain. International journal of yoga8(2), 103. DOI: 10.4103/0973-6131.158470

Type of Study

An experimental study with statistical analysis has been done about the feasibility and effectiveness of yoga in CLBP (Chronic low back pain)

Ethical Approval

Yes, the study has been ethically approved and has followed all the ethical standards tagged with medical experimentation. All the safety measures regarding the clinical condition of the CLBP patients have been followed and consent of the population has been taken before involving them in the yoga therapy.

Justification paragraph using the five components with ARCOC

The authority of this resource is associated with the IYTM (integrated yoga therapy module) guideline for the CLBP patients and the study has been carried out in SVYASA Yoga University. This paper is highly relevant with the condition of Perla Daniel as she has been suffering from CLBP and has intention to take yoga therapy to lead a better lifestyle. The coverage of this paper is to provide an alternative cost-effective and feasible therapy for the mentioned health issue. The population of 12 CLBP patients has been selected and the result has mentioned that yoga therapy is quite feasible, low cost and has a long-lasting positive impact over the pain management of CLBP. Hence, from this angle, the objectivity has been identified and it can be mentioned that the practice is suitable for Perla Daniel. The currency of the paper is unquestionable as it has been published in 2015.

Reference: Resource 5

Qin, J., Zhang, Y., Wu, L., He, Z., Huang, J., Tao, J., & Chen, L. (2019). Effect of Tai Chi alone or as additional therapy on low back pain: Systematic review and meta-analysis of randomized controlled trials. Medicine98(37), 82-104. doi: 10.1097/MD.0000000000017099

Type of Study

This is a systematic review with which metal analysis has also been done.

Ethical Approval

The study is ethically approved and secondary quantitative data has mainly been focused.

Justification paragraph using the five components with ARCOC

The authority of this paper is tagged with seven major authentic databases for medical journals like Cochrane Library, PubMed, Wanfang, CNKI and more. The paper is relevant with the clinical condition of Perla Danielas as she has also thought of Tai Chi therapy to help her CLBP. From the result of the study, it has been identified that Tai Chi helps in pain management along with routine physiotherapy of the patient (Qin et al. 2019). Hence, it can be analysed that only Tai Chi is not sufficient to help the patient of CLBP. The coverage of this paper is all about the effectiveness and viability of Tai Chi. With the objective of identification of the percentage or rate of efficiency of Tai Chi the study has been conducted. However, it has identified that 74% of the population has not got that much effect from this therapy. In the currency of the resource, it can be mentioned that the paper is published in 2019.

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