Suicides in Gerontologic Patients: Interventions

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Articles Appraisal Using Rapid Clinical Appraisal Tools

Throughout the process of research, I have addressed several databases that contained many articles regarding the proposed topic of discussion. I have also found several search engines that helped me to discover quite a few medical articles that perfectly reflected the topic of my research proposal. The very first search engine that I have used is PubMed. It is one of the most popular search engines that features an extensive database containing free medical journal articles. I was able to access MEDLINE and go through numerous records to find the articles that were of interest to me.

The concept of MESH can be easily applied within the framework of this online database and help the end-user to narrow the search results. I was also able to identify several relevant meta-analyses in Cochrane Library. Even though this database is subscription-based, I was able to gain access to several articles regarding my proposal topic. The most important medical article database is Google Scholar. Here, I was able to find every single article I was looking for. The system was easy to navigate, and I had no trouble finding the most relevant evidence that could support my evidence-based research project.

PICOT Question and MESH Terms

PICOT: In gerontologic patients (P), what is the effect of a community-based intervention (I) on the occurrence of suicides (O) compared with conventional interventions (C) within the early stages of terminal illnesses (T)?

Using a search query, I was able to identify a series of results. The majority of research studies aligned with the exact PICOT question, so overall, the results are satisfactory. To my mind, a correctly posed question can make it much easier for the researcher to find the necessary articles and conduct an accurate research project. According to what I have witnessed, MESH terms did not contribute to my research at all. To be more specific, I have gone through MESH terms related to persons, health care, and psychology but was not able to identify any additional information that could be helpful within the framework of this research.

The search queries were community-based intervention geriatric patients and community-based intervention suicide elderly patients. Luckily, I did not have to modify the search to gain access to a better set of articles. I have used PubMed, Cochrane, and Google Scholar. From these three, the latter turned out to be the best in terms of pulling the most relevant articles from the database. The articles from Cochrane and PubMed libraries were not acceptable in terms of reliability and the overall quality of evidence. The problem of availability also impacted my decision regarding the eminence of these databases. The articles that I have found represent an extensive amount of relevant evidence and should be used in the final research project.

One of the articles that were found during the search session was the one written by Brodaty and Arasaratnam (2012). They evaluated the psychological aspects of dementia and studied the community-based intervention that involved the use of nonpharmacological interventions. Overall, the article is rather thorough, and the evidence that is presented by the researchers can be characterized as useful.

Completing the Rapid Critical Appraisal Process

The rapid critical appraisal was not so rapid because I had to analyze the article and review it in detail to decide whether the article can be used or not. Consequently, I can call it a difficult process that interfered with the workflow and was somewhat confusing to me. Nonetheless, I managed to make the best use of reading the abstracts, and this helped me to save major time. In some cases, I have addressed other sections of the paper (where these sections were available), such as findings, discussion, and conclusion.

Getting acquainted with a more comprehensive description of the study helped me to draw a reasonable conclusion each time I looked through another article. To complete the evaluation table and finish the assessment of the articles, I decided to analyze not the abstracts but full papers. This approach worked perfectly because, in most cases, I gained access to a wide-ranging array of evidence. If compared to the information contained in the abstract, the information that is presented in the discussion and conclusion sections is way more useful.

Approach to Synthesizing the Evidence

I have synthesized the evidence following the PICOT question of my research project and tried my best to identify the key variables that could be transferred to my study. The variables that were of interest to me included the performance of the community-based intervention, patient outcomes and satisfaction, nurses involvement in the process, and the overall costs of the project (Kim & Yang, 2017). Both of the articles that I have identified during the previous step perfectly reflect the core objective of my proposal and the methods that I am willing to employ when completing the assignment.

The article written by Brodaty and Arasaratnam (2012) presented a great deal of evidence related to the implementation of nonpharmacological medications in geriatric patients with dementia to reduce the occurrence of suicides and raise the patients awareness concerning their illness. The evidence showed that this kind of community-based intervention positively affects the psychological health of the patients (Moyle, Parker, & Bramble, 2014). The statistics presented by the authors can support the rigor of the evidence. The adverse reactions in both patients and caregivers were also minimized.

The article written by Coburn, Marcantonio, Lazansky, Keller, and Davis (2012) supports the evidence offered by the previous authors and expands the knowledge regarding the reduction of mortality among terminally ill geriatric patients are inclined to commit suicide during the early stages of their illness. The level of evidence supported the major role of nurses in the development and implementation of a community-based intervention (Coburn et al., 2012). The patients were satisfied with the program but had a hard time adjusting to it.

Narrative Descriptions of the Found Studies

The quality of the evidence presented in both Brodaty and Arasaratnam (2012) and Coburn et al.s (2012) articles can be characterized as acceptable. I believe that the findings of their studies are rather noteworthy within the framework of my evidence-based project because they are relevant and accurate. The evidence presented by the authors reflects the community-based intervention that I am planning to implement. I propose to create a community program that will involve different activities such as physical exercises, games, spoken interaction, and many more interpersonal activities that are expected to motivate the patients and help them to live a happier life (Kennedy-Malone, Fletcher, & Plank, 2014).

Also, I would like to monitor the patients and counsel them to minimize the risk of committing suicide and raise their self-awareness. In perspective, this is expected to create a positive environment and help the patients better cope with their illnesses.

References

Brodaty, H., & Arasaratnam, C. (2012). Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia. American Journal of Psychiatry, 169(9), 946-953. Web.

Coburn, K. D., Marcantonio, S., Lazansky, R., Keller, M., & Davis, N. (2012). Effect of a community-based nursing intervention on mortality in chronically ill older adults: A randomized controlled trial. PLoS Medicine, 9(7), 2-17. Web.

Kennedy-Malone, L., Fletcher, K. R., & Plank, L. M. (2014). Advanced practice nursing in the care of older adults. Philadelphia, PA: F.A. Davis Company. Web.

Kim, J., & Yang, J. (2017). Effectiveness of a community-based program for suicide prevention among elders with early-stage dementia: A controlled observational study. Geriatric Nursing, 38(2), 97-105. Web.

Moyle, W., Parker, D., & Bramble, M. (2014). Care of older adults: A strengths-based approach. Port Melbourne, Australia: Cambridge University Press. Web.

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