This assignment is a building block for your final Synthesis of Literature assignment. Your synthesis paper will not simply be a summary of articles you have found based on your literature search. Rat

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This assignment is a building block for your final Synthesis of Literature assignment. Your synthesis paper will not simply be a summary of articles you have found based on your literature search. Rather, you will identify relationships of the articles you found and group them to understand what is known about your topic of interest. Altogether, what does the evidence mean? How does it relate to your problem and population of interest. How will the evidence guide your DNP project idea?

For this assignment

1. Write a short (1 page limit) paragraph describing your search strategy. Include clinical question, keywords, databases, limits, inclusion/exclusion criteria and number of results. Review the Kable, Pich & Maslin-Prothero (2012) article linked in Module readings for guidelines to document your search strategy.

2. Refine PRISMA diagram submitted in Module 4 Discussion Board.

3. Organize your literature search by developing an evidence table (a minimum of 4-5 articles required for this assignment, however, a total of 7-10 articles will be expected to be in your evidence table in your final synthesis of literature assignment). Use the Evidence Table Template  downloadprovided to organize the articles you found during your literature search. Remember to be concise in your Evidence Table, as you continue adding evidence you want to easily be able to find the important information from each article that will inform your DNP project idea. Avoid unnecessary words and directly quoting from articles. **No systematic reviews or meta-analysis of any kind are permitted for this assignment.

For submission of this assignment, combine Search Strategy paragraph, PRISMA diagram, Evidence Table and Reference page using APA format into one document. Include a title page. Review rubric before submission.

**Highly recommend using a reference manager (i.e. EndNote, Mendeley, Zotero) to keep track of articles related to your topic of interest throughout your DNP Project courses. Consult Mr. Andy Todd or the UCF Library tools if needed.


RubricLiterature Search & Evidence TableLiterature Search & Evidence

TableCriteriaRatingsPtsThis criterion is linked to a Learning OutcomeSearch StrategyClinical question in PICOT format, keywords, databases, exclusion/inclusion criteria and results are clearly defined and documented.4 pts

This criterion is linked to a Learning OutcomePRISMA Flow DiagramPRISMA Flow diagram is complete and accurate2 pts

This criterion is linked to a Learning OutcomeEvidence TableTable is complete with information (purpose, sample/setting, intervention, outcome measures, strengths/limitations, findings, level of evidence) documented accurately in appropriate columns. 4-5 articles related to topic of interest are included in table.10 pts

This criterion is linked to a Learning OutcomeKey FindingsBullet points of a synthesis of key findings from articles complete, concise, and accurate.2 pts

This criterion is linked to a Learning OutcomeFacilitators/BarriersBullet points of facilitators/barriers to the potential implementation of a DNP project based on evidence found is complete, concise, and accurate.2 pts

This criterion is linked to a Learning OutcomeRecommendationsBullet points of recommendations for practice is complete, concise, and accurate.2 pts

This criterion is linked to a Learning OutcomeReferencesReferences accurately written in APA format1 pts

This criterion is linked to a Learning OutcomeScholarly WritingScholarly tone, clarity of writing, concise with few or no formatting, grammar or syntax errors, APA format is appropriately used2 pts

Total Points: 25 Module 4 Discussion: Search Strategy & PRISMA Diagram” style=”float: left;”>Previous Module 4 Summary” style=”float: right;”>Next

This assignment is a building block for your final Synthesis of Literature assignment. Your synthesis paper will not simply be a summary of articles you have found based on your literature search. Rat
Impoverished Elderly Living with Diabetes Impoverished Elderly Living with Uncontrolled Type II Diabetes Leonne M. Reid University of Central Florida Department of Nursing Practice & Department of Nursing Systems, College of Nursing NGR 7855C: Evidence-Based Practice Development for DNP Dr. Jean Davis March 14, 2021 I have done extensive research and have found 158 articles that I will be reading and finding evidence to support my clinical question. Clinical Question: Does the impoverished elderly and migrant patients with uncontrolled Diabetes type II and high HGBA1C the same Comparing than a population that I not impoverished? Problem statement: What is the percentage of diabetes that are living below the poverty line in the rural areas. Practice gap: The group of elderly living with type 2 diabetes that is uncontrolled. Some of the consequences if the diabetes remain uncontrolled is peripheral vascular disease, microvascular complications, retinopathy, cardiovascular disease possible amputations. Some of the benefits of having controlled blood sugars, helps reduce kidney disease, stroke, heart failure and poor circulation to the limbs possibly leading to amputations of limbs or toes. When a patient’s diabetes level is managed it helps empower them during the diabetic process. To teach and coach and guide patients helps them understand the diabetes. Educating on how it affects their personal lives. It allows them to meet behavioral changes to improve their health. The clinical problem is that Diabetic education is essential part to control to avoid long term health care complications.
This assignment is a building block for your final Synthesis of Literature assignment. Your synthesis paper will not simply be a summary of articles you have found based on your literature search. Rat
PRISMA 2009 Flow Diagram pub Records excluded Foreign language mot scientific papers n=223 Records after duplicates removed(n =4310 ) Records identified through database searchingPubmed n=225 Cinahl n=595 Cochrane systematic review n=17 Cochrane clinical trials n= 713 Studies included in quantitative synthesis (meta-analysis)(n =21 ) Studies included in qualitative synthesis(n =21 ) Full-text articles excluded, with reasons(n =48 ) Full-text articles assessed for eligibility(n =69 ) Records excluded(n = 4018 ) Records screened(n =4087 ) Identification Eligibility Included Screening From: Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(7): e1000097. doi:10.1371/journal.pmed1000097 For more information, visit www.prisma-statement.org.
This assignment is a building block for your final Synthesis of Literature assignment. Your synthesis paper will not simply be a summary of articles you have found based on your literature search. Rat
STUDENT NAME: Leonne Reid Clinical Question: Does the impoverished elderly and migrant patients with uncontrolled Diabetes type II and high HGBA1C the same Comparing than a population that I not impoverished? Source Study Purpose Sample & Setting Intervention Outcomes Measured Findings Strengths/Limitations Level of Evidence** A Community–Academic Collaboration to Support Chronic Disease Self-Management among Individuals Living in Permanent Supportive Housing Pilot data from this study provides an example of a community–academic partnership that improved the health of individuals Individuals experiencing chronic homelessness with a chronic health condition may qualify for permanent supportive housing (PSH).   Diabetes self-management as a priority health need. An evidence-based diabetes self-management program was piloted for seven weeks with diabetic (type 2) or prediabetic PSH residents. A survey was administered at baseline and program completion. HbA1c was assessed at baseline and 3-month follow-up.  Those who completed the Program (N = 10), reported a significant increase in diabetes knowledge, self-efficacy, and foot self-care. The average hemoglobin A1c (HbA1c) of the participants significantly decreased from 8.86 to 6.88. In the open-ended assessment, all participants reported that they learned something from this program. Some reported an increase in specific knowledge. Whereas others talked about how the program changed their perceptions The implementation of the program had several limitations. Despite successful outcomes for those who stayed in the program, the attrition rate was high with few participants graduating from the program. Interpretations from the study were limited by the statistical power resulting from the small sample size which may have prevented the detection of between-person differences.   Culturally Appropriate Self-Management Program for Hispanic Adults with Type 2 Diabetes and Low Health Literacy Skills This study assessed the feasibility of adapting a patient-centered educational intervention for type 2 diabetes (T2D) self-management for a Hispanic population with low health literacy skills. The rural community health center from which the participants were recruited provides primary health care to an underserved and underinsured population. Effective interventions for lowering HbA1c levels included the use of low carbohydrate or low glycemic load diets, physical activity, and the use of glucose self-monitoring, in a diabetes self-management program. Participants’ feedback clustered around four themes: information and knowledge, motivation and barriers to change, experiences with new behaviors, and personal responsibility. The findings may help in further development of tools and strategies for improved T2D self-management in the study population. Limitations of this study include the potential for biases related to participant self-selection and the fact that the Spanish-speaking group facilitator also presented the content. Another limitation was that the group participants had a lower level of health literacy skills than anticipated, which provided linguistic challenges  This descriptive qualitative study used a phenomenological approach A Group-Based Peer Support Program for Low-Income African Americans with Type 2 Diabetes: A Descriptive Phenomenological Study The purpose of this study was to explore and describe the meaning and essence of the experiences, perceptions of African American adults with type 2 diabetes who participated in a peer support program to promote diabetes self-management A convenience sample of 20 participants were drawn from two peer support programs African American with type 2 diabetes in a city in the southeastern region of the United States. Included in the peer support programs were Medicaid and uninsured patients. The peer support programs were organized and supervised by nurses. In addition to the monthly meetings, the trained peer supporters called or visited the patients at least once in two weeks. Many of them HGBA1c. The peer supporters who themselves have diabetes and were doing well with their disease management (A1C of 7 and below). Twenty participants were interviewed for the study, comprising 13 females and seven males aged between 30 – 82 years. Five participants were married, 14 were single/ divorced, four attended some high school, nine completed high school, seven attended some college, four were employed, 11 were unemployed, and four were retired. Several researchers have demonstrated the benefits of peer support in terms of enhanced disease control, cost-effectiveness, reaching low-income rural dwellers, and psychosocial well-being A limitation of this study is that participants were sampled from only two peer support programs in one city in the Southeastern United States, limiting the generalizability of findings. T The philosophical underpinning that guided this study is descriptive phenomenology A Patient-Centered Approach Using Community-Based Paraprofessionals to Improve Self-Management of Type 2 Diabetes The purpose of this study was to examine the impact of a 10-week lifestyle management program delivered by community-based paraprofessionals in improving clinical markers and dietary behaviors related to diabetes control in an underserved population. A total of 156 people completed baseline data collection and enrolled in the program. In particular, 57% were Caucasian, 37% were African American, 3% were Hispanic, and 3% were American Indian/Alaskan Native. Participants were 27 to 83 years of age (mean age was 55 years) and 76% were female. Participants in Diabetes Health: Its in Your Hands met for 10 weeks—one time each week for approximately 90 minutes. Each of the 10 sessions was led by a trained MSU-E paraprofessional who was supervised by county-based professional staff  Paired t tests indicated significant changes for: HbA1c (P < .001), BMI (P < .05), smoking tobacco (P < .05), fruit and vegetable intake (P < .01), and appraisal of diabetes scores (P < .001). A significant decrease in HbA1c levels (P < .001) and BMI (P < .05) from baseline to follow-up.  a higher score indicates a movement toward positive health-related changes, such as decreasing tobacco smoking or increasing fruit and vegetable intake.  The absence of a control group may be perceived as a study limitation. A quasi-experimental design that was more appropriate for our real-world situation. A Pilot Study of Diabetes Education via Telemedicine in a Rural Underserved Community—Opportunities and Challenges Purpose Telemedicine technology may offer an avenue to implement diabetes self-management education (DSME) for people with diabetes in underserved rural communities.  A pilot study was conducted in 2006, implementing a DSME-T at the University of Arkansas for Medical Sciences and a rural community hospital in Arkansas (Ozark Health, Inc). A total of 38 people were enrolled to receive DSME-T. The American Diabetes Association recommends that DSME be provided to patients by a registered dietician and nurse, following a core curriculum. Results A total of 66% of participants (n = 25) completed the DSME-T program. A significantly greater proportion of participants demonstrated improved knowledge (39% vs 83%; P = .012), endorsed greater self-efficacy (54% vs 86%; P = .016), and reported more frequent self-care practices to manage their diabetes at the conclusion of the study period. Plans are in place to explore the possibility of sustaining and expanding the program to other underserved rural communities. Limited to the campus of University of Arkansas. Most of these studies were conducted in urban settings with adequate access to diabetes care. Studies on DSME in rural underserved communities have been limited. A quantitative research **Please cite the level of evidence grading schema you used (e.g., Johns Hopkins, Melnyk & Fineout-Overholt, etc.) Synthesis of Key Findings (include in-text citation): 1. Type II Diabetes 2. Impoverished elderly 3. Medication management /compliance Potential Facilitators/Barriers to Implementing a Potential DNP Project Based on the Evidence/Outcome Measures: 1. Illiteracy 2. Taking time off work or having family support to attend the workshop. Recommendations for Practice: Life style changes Maintain follow visit 4-5 per year Maintain a balance diet/exercise 3 days a week References (APA Format) – recommended to import from reference manager (i.e. EndNote, Mendeley, Zotero) Balamurugan, A., Hall-Barrow, J., Blevins, M. A., Brech, D., Phillips, M., Holley, E., & Bittle, K. (2009). A Pilot Study of Diabetes Education via Telemedicine in a Rural Underserved Community—Opportunities and Challenges. The Diabetes Educator, 35(1), 147–154. Brunk, D. R., Taylor, A. G., Clark, M. L., Williams, I. C., & Cox, D. J. (2017). A Culturally Appropriate Self-Management Program for Hispanic Adults with Type 2 Diabetes and Low Health Literacy Skills. Journal of Transcultural Nursing, 28(2), 187–194. Okoro, F. (2020). A Group-Based Peer Support Program for Low-Income African Americans with Type 2 Diabetes: A Descriptive Phenomenological Study. ABNF Journal, 31(1), 12–18. Schick, V., Witte, L., Isbell, F., Crouch, C., Umemba, L., & Peña-Purcell, N. (2020). A Community–Academic Collaboration to Support Chronic Disease Self-Management among Individuals Living in Permanent Supportive Housing. Progress in Community Health Partnerships: Research, Education, and Action 14(1), 89-99. Amy Saxe-Custack & Lorraine Weatherspoon (2013). A Patient-Centered Approach Using Community-Based Paraprofessionals to Improve Self-Management of Type 2 Diabetes, American Journal of Health Education, 44:4, 213-220, DOI: 10.1080/19325037.2013.798213

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