Literature Review Matrix

Searching and Critiquing the Evidence

The practice problem used last week was on Evidence-based practice protocol to improve glucose control in individuals with type 2 diabetes mellitus, and the theoretical framework used was the Orem's Mid-Range Theory of Self-Care. There are various research studies that have been done on the outcome of self-care on Type 2 Diabetes Mellitus patients. In most of the studies, the most prevalent results are that self-care is an effective method of improving the health and lifestyle outcomes of Type 2 Diabetes patients. Krishna and Boren (2008) conducted a systematic review of evidence-based studies done between 1996 and 2007. The study analyzed 18 researches done within the selected time period and found that using phone calls and text messages to assist diabetes patients could improve the self-management outcomes. Shrivastava et al. (2013) analyzed the effectiveness of self-management for the diabetes mellitus patients. The study found that self-care helps to reduce the rate of morbidity and mortality among diabetes patients.

In addition, Steinsbekk et al. (2013) conducted a meta-analysis comparing the differences between the outcomes of group based self-management education and routine treatment for Type 2 diabetes patients. The study analyzed 21 studies that included studied on 2833 participants. The results of the meta-analysis showed that group-based self-management education helped to improve the psychosocial, clinical, and lifestyle outcomes among the diabetes patients. Lastly, Tang et al. (2008) examined the impact of social support and quality of life on the self-care behaviors of African American Type 2 diabetes patients. The study followed an observational design with 89 African-American adults, who were aged 40 and above. The study found that social support is vital for self-management to be effective in diabetes treatment.

The selected studies have helped to strengthen the merit of my selected theoretical framework. The theory selected for the study was Dorothea Orem’s Self Care Theory. These studies have helped to demonstrate some important evidence-based facts about the effectiveness of self-care for diabetes patients hence helping to prove the credibility of the theory. The scrutiny of these studies has helped to discover the degree of effectiveness of this theory and the best application methods that can make it an effective approach to improving the outcomes of patients with Type 2 Diabetes Mellitus.

Levels of Evidence in the Articles

The classification of the level of evidence of a given research is important in evidence-based studies because they help to show how accurate, credible, or reliable a research is (Gray, Grove & Sutherland, 2017). The most prevalent evidence in the research articles analyzed is Level II evidence. Level II evidence is one that is obtained from at least one randomized control trial (Moran, Burson & Conrad, 2017). The articles by Krishna and Boren (2008) and Steinsbekk et al. (2013) conducted meta-analyses of various researches but not all of them were randomized control trials hence the studies do not qualify for Level I evidence.

The reason why Level II evidence is the most prevalent is because it has a high degree of accuracy which is important given the seriousness of the problem being studied. Other levels of evidence that have been identified in the articles include Level IV and VI. The article by Tang et al. (2008) can be classified as Level IV evidence because it includes evidence from well-designed case controls and cohort studies. On the other hand, Shrivastava et al. (2013) is classified as Level VI evidence because it is a single qualitative and descriptive study. The article does not include any form of evidence based research.

References

Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO:Saunders Elsevier.

Krishna, S., & Boren, S. A. (2008). Diabetes self-management care via cell phone: a systematic review. Journal of diabetes science and technology, 2(3), 509-517. DOI: 10.1177/193229680800200324

Moran, K., Burson, R., & Conrad, D. (2017). The doctor of nursing practice scholarly project: A framework for success (2nd ed.). Burlington, MA: Jones & Bartlett Learning.

Shrivastava, S. R., Shrivastava, P. S., & Ramasamy, J. (2013). Role of self-care in management of diabetes mellitus. Journal of Diabetes & Metabolic Disorders, 12(1), 14. DOI: 10.1186/2251-6581-12-14

Steinsbekk, A., Rygg, L., Lisulo, M., Rise, M. B., & Fretheim, A. (2012). Group based diabetes self-management education compared to routine treatment for people with type 2 diabetes mellitus. A systematic review with meta-analysis. BMC health services research, 12(1), 213. DOI: 10.1186/1472-6963-12-213

Tang, T. S., Brown, M. B., Funnell, M. M., & Anderson, R. M. (2008). Social support, quality of life, and self-care behaviors among African Americans with type 2 diabetes. The Diabetes Educator, 34(2), 266-276. DOI: 10.1177/0145721708315680