NR716 Week 6 Assignment: Translation Science and Synthesis

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NR716 Week 6 Assignment: Translation Science and Synthesis – Step-by-Step Guide With Example Solution

The first step before starting to write the NR716 Week 6 Assignment: Translation Science and Synthesis is to understand the requirements of the assignment. The first step is to read the assignment prompt carefully to identify the topic, the length and format requirements. You should go through the rubric provided so that you can understand what is needed to score the maximum points for each part of the assignment. 

It is also important to identify the paper’s audience and purpose, as this will help you determine the tone and style to use throughout. You can then create a timeline to help you complete each stage of the paper, such as conducting research, writing the paper, and revising it to avoid last-minute stress before the deadline. After identifying the formatting style to be applied to the paper, such as APA, review its use, including writing citations and referencing the resources used. You should also review the formatting requirements for the title page and headings in the paper, as outlined by Chamberlain University.

How to Research and Prepare for NR716 Week 6 Assignment: Translation Science and Synthesis

The next step in preparing for your paper is to conduct research and identify the best sources to use to support your arguments. Identify a list of keywords related to your topic using various combinations. The first step is to visit the Chamberlain University library and search through its database using the important keywords related to your topic. You can also find books, peer-reviewed articles, and credible sources for your topic from the Chamberlain University Library, PubMed, JSTOR, ScienceDirect, SpringerLink, and Google Scholar. Ensure that you select the references that have been published in the last 5 years and go through each to check for credibility. Ensure that you obtain the references in the required format, such as APA, so that you can save time when creating the final reference list. 

You can also group the references according to their themes that align with the outline of the paper. Go through each reference for its content and summarize the key concepts, arguments and findings for each source. You can write down your reflections on how each reference connects to the topic you are researching. After the above steps, you can develop a strong thesis that is clear, concise and arguable. Next, create a detailed outline of the paper to help you develop headings and subheadings for the content. Ensure that you plan what point will go into each paragraph.

How to Write the Introduction for NR716 Week 6 Assignment: Translation Science and Synthesis

The introduction of the paper is the most crucial part, as it helps provide the context of your work and determines whether the reader will be interested in reading through to the end. Begin with a hook, which will help capture the reader’s attention. You should contextualize the topic by offering the reader a concise overview of the topic you are writing about so that they may understand its importance. You should state what you aim to achieve with the paper. The last part of the introduction should be your thesis statement, which provides the main argument of the paper.

How to Write the Body for NR716 Week 6 Assignment: Translation Science and Synthesis

The body of the paper helps you to present your arguments and evidence to support your claims. You can use headings and subheadings developed in the paper’s outline to guide you on how to organize the body. Start each paragraph with a topic sentence to help the reader know what point you will be discussing in that paragraph. Support your claims using the evidence collected from the research, and ensure that you cite each source properly using in-text citations. You should analyze the evidence presented and explain its significance, as well as how it relates to the thesis statement. You should maintain a logical flow between paragraphs by using transition words and a flow of ideas.

How to Write the In-text Citations for NR716 Week 6 Assignment: Translation Science and Synthesis

In-text citations help readers give credit to the authors of the references they have used in their work. All ideas that have been borrowed from references, any statistics and direct quotes must be referenced properly. The name and date of publication of the paper should be included when writing an in-text citation. For example, in APA, after stating the information, you can put an in-text citation after the end of the sentence, such as (Smith, 2021). If you are quoting directly from a source, include the page number in the citation, for example (Smith, 2021, p. 15). Remember to also include a corresponding reference list at the end of your paper that provides full details of each source cited in your text. An example paragraph highlighting the use of in-text citations is as below:

“The integration of technology in nursing practice has significantly transformed patient care and improved health outcomes. According to Morelli et al. (2024), the use of electronic health records (EHRs) has streamlined communication among healthcare providers, allowing for more coordinated and efficient care delivery. Furthermore, Alawiye (2024) highlights that telehealth services have expanded access to care, particularly for patients in rural areas, thereby reducing barriers to treatment.”

How to Write the Conclusion for NR716 Week 6 Assignment: Translation Science and Synthesis

When writing the conclusion of the paper, start by restating your thesis, which helps remind the reader what your paper is about. Summarize the key points of the paper by restating them. Discuss the implications of your findings and your arguments. Conclude with a call to action that leaves a lasting impression on the reader or offers recommendations.

How to Format the Reference List for NR716 Week 6 Assignment: Translation Science and Synthesis

The reference helps provide the reader with the complete details of the sources you cited in the paper. The reference list should start with the title “References” on a new page. It should be aligned center and bolded. The references should be organized in an ascending order alphabetically, and each should have a hanging indent. If a source has no author, it should be alphabetized by the title of the work, ignoring any initial articles such as “A,” “An,” or “The.” If you have multiple works by the same author, list them in chronological order, starting with the earliest publication. 

Each reference entry should include specific elements depending on the type of source. For books, include the author’s last name, first initial, publication year in parentheses, the title of the book in italics, the edition (if applicable), and the publisher’s name. For journal articles, include the author’s last name, first initial, publication year in parentheses, the title of the article (not italicized), the title of the journal in italics, the volume number in italics, the issue number in parentheses (if applicable), and the page range of the article. For online sources, include the DOI (Digital Object Identifier) or the URL at the end of the reference. An example reference list is as follows:

References

Morelli, S., Daniele, C., D’Avenio, G., Grigioni, M., & Giansanti, D. (2024). Optimizing telehealth: Leveraging Key Performance Indicators for enhanced telehealth and digital healthcare outcomes (Telemechron Study). Healthcare, 12(13), 1319. https://doi.org/10.3390/healthcare12131319

Alawiye, T. (2024). The impact of digital technology on healthcare delivery and patient outcomes. E-Health Telecommunication Systems and Networks, 13, 13-22. 10.4236/etsn.2024.132002.

NR716 Week 6 Assignment: Translation Science and Synthesis Instructions

Purpose

The purpose of this assignment is to develop a revised evidence synthesis paper using the Week 4 assignment submission and integrating course faculty feedback. This assignment provides you with the opportunity to create a practice question and identify a translation science theory or model to serve as the framework for a practice change project. Have a look at NR716 Week 7 Discussion | Appraising Systematic Reviews.

Instructions

Follow these guidelines when completing the assignment. Contact your course faculty if you have any questions.

  1. Review the course faculty feedback on the Week 4 Assignment and make revisions incorporating the course faculty feedback.
  2. Add to the paper by writing a one sentence clear and concise practice question.
  3. Add to your revised Week 4 paper by identifying and presenting a translation science theory or model to serve as the framework for a practice change project.
  4. Use a synthesis style of writing in every section (1, 2, 3, & 4) of the paper when incorporating research evidence and non-research evidence. 
  5. Use the most current version of Microsoft Word that is the format for all Chamberlain University College of Nursing. You can tell the document is saved as the current version because it will end in “docx.”
  6. All Chamberlain University policies related to plagiarism must be observed. This written assignment will be screened for originality by Turnitin.
  7. Review the rubric for the grading criteria.

The assignment includes the following components:

  1. Introduction
    1. Use a synthesis of research evidence and non-research evidence when writing this section of the paper. 
    2. Write a one-sentence purpose statement.
    3. Introduce the practice problem.
    4. Introduce the evidence-based intervention using research evidence.
  2. Analysis of the Practice Problem (1-2 paragraphs)
    1.  Use a synthesis of research evidence and non-research evidence when writing this section of the paper.
    2. Present the following at the national and local levels:
      1. Significance
      2. Prevalence
      3. Mortality
      4. Economic ramifications of the practice problem
  3. Evidence Synthesis (minimum of 3 quantitative research articles)
    1. Use a synthesis of research evidence when writing this section of the paper.
    2. Identify the main themes and salient points that emerge from a synthesis of research evidence.  
    3. Compare and contrast the main points from a synthesis of research evidence.
    4. Present an objective overarching synthesis of research evidence about the intervention.  
  4. Practice Question: Write a one sentence clear and concise practice question that includes the following:
    1. Population
    2. Intervention
    3. Comparison
    4. Outcome(s)
    5. Timeframe
  5. Selection of a Translation Science Theory or Model (2-3 paragraphs)
    1. Apply a translation science theory or model to support the practice change project.
    2. Determine how the identified translation science theory or model serves as the framework for the design of a practice change project.
    3. Propose how stakeholders are integrated into the phases of the selected theory or model.
  6. Conclusion
    1. Use a synthesis of research evidence and non-research evidence when writing this section of the paper.
    2. Write one concise paragraph providing a clear and logical summation of the paper.
  7. Appendix A: Attach the completed Johns Hopkins Individual Evidence Summary Tool as Appendix A. Complete all sections of the Johns Hopkins Individual Evidence Summary Tool for each research study Include the following:
    1. Include a minimum of three quantitative research studies.
    2. Complete all sections completely and identify the quality and the levels of evidence.
Writing Requirements (APA format)
  • Length: 6-8 pages (not including title page or references page)
  • 1-inch margins
  • Double-spaced pages
  • 12-point Times New Roman or 11-point Arial font
  • Headings & subheadings
  • In-text citations
  • Title page
  • References page
  • Standard English usage and mechanics
Course Outcomes

This assignment enables the student to meet the following course outcomes:

  1. Analyze research and non-research data for the purposes of critical appraisal and judgment of evidence for translation into practice. (POs 1, 3, 5, 7, 9)
  2. Justify the use of translation science theory when designing, implementing, and evaluating a practice change project. (POs 3, 4, 5, 6, 8, 9)
  3. Formulate an emerging practice question focusing on the evidence-based intervention to influence practice outcomes. (POs 1, 3, 4, 5, 6, 7, 9)
  4. Synthesize high-level research and non-research evidence relevant to practice problems. (POs 1, 3, 5, 9)

NR716 Week 6 Assignment: Translation Science and Synthesis Example

Translation Science and Evidence Synthesis (POSTED)

Evidence Synthesis

Evidence synthesis is a way of putting relevant information on a particular research question or problem together to identify knowledge gaps, selecting evidence-based information to inform, or making essential decisions in the field. It helps identify the connection between two or more sources, thereby deriving a conclusion based on the required evidence. Additionally, evidence synthesis is typically unbiased in supporting decision-making or addressing a specific practice problem. This paper aims to present an evidence synthesis of the diabetes practice problem based on three quantitative articles and non-research evidence sources.

Introduction to the Practice Problem

The selected national practice problem is diabetes. Diabetes is a health condition that affects glucose regulation in the body. Diabetes is characterized by inadequate insulin production or problems with insulin use, thus increasing blood glucose levels. The three primary types of diabetes include type 1, type 2, and gestational diabetes. Type 1 diabetes is characterized by inadequate/lack of insulin production. In type 2 diabetes, the body resists insulin or does not produce adequate insulin.

Gestational diabetes is common in pregnancy but mainly disappears after giving birth. However, gestational diabetes increases the risk of type 2 diabetes diagnosis in the woman’s life (CDC, n.d.). Diabetes is a significant health concern and practice problem since it adversely affects the patient’s life quality, increases the risk of other health conditions such as cardiovascular diseases, and contributes to lifestyle changes. Additionally, diabetes increases healthcare costs and exerts pressure on the entire healthcare system.

Introduction of the Evidence-Based Intervention

The evidence-based intervention selected for this project is Diabetes Self-Management Education (DSME). DSME is a tool used to educate diabetic patients, empower them to make informed self-management decisions, and effectively implement self-management activities. It improves health behaviors and outcomes for people living with diabetes. According to Hermanns et al. (2020), DSME is primarily delivered in 6-week programs, where patients are taught various diabetes self-management activities and best practices. DSME has been found to improve the health outcomes of diabetes patients by positively impacting their self-care behavior and empowering them through increased knowledge and self-efficacy regarding diabetes (Hailu et al., 2019).

Analysis of the Practice Problem

Diabetes as a practice problem is one of the significant health concerns globally. Despite experts maintaining that diabetes is preventable and controllable (Streit & Spritzer, 2022), it potentially overwhelms healthcare systems as it influences patient comorbidities, time spent in the hospital, and readmissions (Ellahham, 2020) and negatively affects economies and individual lives (‘O’Connell & Manson, 2019). Approximately 422 million people have diabetes globally, with a higher burden in low and middle-income nations (WHO, n.d.).

More so, there is an alarming rise in newly diagnosed diabetes cases, and many remain undiagnosed. In their Aetna diabetes white paper publication, George et al. (2019) contend that the weight of the burden of the practice problem is mainly increased by ineffective prevention strategies, late-stage diagnosis, low screening rates, underequipped care facilities, and the scarcity of diabetes specialists. In my opinion, and based on this evidence, diabetes increases an individual/family’s economic burden, following increased healthcare costs, decreased productivity, and high insurance costs.        

Significance, Prevalence, Mortality, and Economic Ramifications of the Practice Problem

The significance of diabetes is profound and felt globally. The disease increases the risk of early death, and diabetes complications negatively impact the patient’s quality of life. Diabetes is also related to various health issues, including amputations, heart disease, loss of sight, kidney failure, and stroke. Additionally, current research shows that diabetes has been found to positively affect hearing loss, dementia, and different forms of cancer, especially in older populations (CDC, n.d.). At the local level, diabetes has contributed to increased numbers of the blind and physically impaired following diabetic foot amputations, poor outcomes, and poor quality of life for diabetic patients with other comorbidities.   

The global diabetes prevalence stands at 8.8% of the total population, with approximately 77% living in developing countries. The prevalence is anticipated to increase to 9.9% by 2045 (Standl et al., 2019). Regarding age distribution, people aged 40-59 are most affected by the condition. In the US, diabetes prevalence lies at 11.3% (approximately 37.3 million) of the total population, with about 8.5 million undiagnosed cases (CDC, 2022). Furthermore, 1 in 9 deaths globally is associated with diabetes and diabetes complications. Diabetes is ranked as the seventh leading cause of mortality in the US and is attributed to 102,188 deaths (CDC, n.d.). In Florida, 13.1% of the adult population, or approximately 2,350,321, are diabetic. According to Khan et al. (2021), the country-level age-adjusted prevalence of diabetes ranges from 4.7% to 17.8%.   

According to Standl et al. (2019), diabetes significantly impacts the economy and the economic productivity of affected individuals. Moreover, it has a significant impact on healthcare systems due to increased care costs incurred in treating and managing the condition and its associated complications. Every 1 in 4 dollars in the US healthcare system is spent on diabetes and diabetes complications treatment and management, and $237 billion is spent on diabetes treatment direct costs (CDC, n.d.).

Additionally, Standl et al. (2019) state that individuals with diabetes spend close to four times more than individuals without diabetes due to medication costs, lifestyle adjustments, follow-ups, and hospitalizations. Diabetes also impacts the productivity of an individual by reducing their efficiency at work, increasing absenteeism, and, therefore, lowering outputs. It also impacts local and national economies by reducing the gross domestic product (Standl et al., 2019). Additionally, diabetes costs approximately $25 billion in Florida annually (Khan et al., 2021).

Evidence Synthesis

I searched reputable data sources to locate three quantitative articles that can be used to address the problem of diabetes practice. The Google search engine, Google Scholar database, PubMed, and CINAHL were used. The articles are peer-reviewed, published in recognized journals, and have been published within the last five years, making them appropriate for addressing the practice problem. The three articles, Zheng et al. (2019), focus on Diabetes Self-management Education; Seboka et al. (2021) focus on the use of information technology in diabetes management; and Fang et al. (2021) focus on diabetes and the risk of hospitalization for infection.

The sources contribute to addressing the national practice problem of diabetes. The primary aim that is salient in the three sources is to provide recommendations that can be used to improve the lives of diabetes patients, as they all cover the essential aspects of diabetes. The main themes emerging from synthesizing the three research evidence sources include diabetes self-management education, healthcare technology, and hospitalization risk for patients with diabetes (Fang et al., 2021; Seboka et al., 2021; Zheng et al., 2021).

The salient points in the evidence synthesis include that diabetes complications are the primary cause of hospitalization for patients with diabetes (Fang et al., 2021). However, diabetes complications can be prevented and reduced through empowerment via diabetes self-management education (Zheng et al., 2021), which can be effectively implemented using healthcare technology (Seboka et al., 2021). Another key point is that healthcare technology-assisted DSME is effective in improving diabetes self-management behaviors, which in turn reduces the risk of complications and related hospitalizations, thereby enhancing the overall quality of life for patients (Jain et al., 2020).

Comparison and Overarching Objective of the Main Points from the Research Evidence Synthesis

The three research evidence sources aim at addressing the practice problem by improving patient outcomes. As mentioned earlier, diabetes self-management education, healthcare technology, and hospitalizations related to complications significantly influence patient outcomes in individuals with diabetes (Fang et al., 2021; Seboka et al., 2021; Zheng et al., 2021). Additionally, healthcare technology has facilitated the use of DSME and self-management behavior (Seboka et al., 2021; Zheng et al., 2021), thereby helping to prevent complications that increase the risk of hospitalization (Fang et al., 2021) and other related comorbidities and mortality.

However, pertinent differences exist in the main points from the research evidence obtained. Foremost, Seboka et al. (2021) note that the perception of the care providers majorly influences the use of healthcare technology in facilitating diabetes management and diabetes self-management. On the other hand, Fang et al. (2021) only focus on diabetes as a risk for hospitalization but fail to include parameters of exclusion of diabetes and non-diabetes-related infections that can lead to hospitalization.

In addition, Zheng et al. (2021) emphasized the effectiveness of DSME in promoting diabetes self-management behaviors and practices in T2DM patients only. The disparities notwithstanding, the overarching objective in the three research evidence sources, as evident in the synthesis, is that DSME, utilizing healthcare technology (Seboka et al., 2021), can help promote self-management behavior, thus reducing complications leading to hospitalizations (Fang et al., 2021), hence improving patient outcomes and quality of life (Fang et al., 2021; Seboka et al., 2021; Zheng et al., 2021).

Practice Problem

Among Type 2 Diabetes patients, does DSME utilizing healthcare technologies, compared to routine patient education, reduce diabetes-related complications within six months?

Translation Science Theory, Application, and Stakeholder Integration

The translation science theory selected for the implementation of the practice change project is the Normalization Process Theory. The theory addresses the elements needed to implement and integrate a particular intervention into routine processes successfully. It serves as a framework for designing a practice change project to guide the planning and implementation of enhancing the intervention’s integration into routine work. Reflexive monitoring is one of the theory’s elements, which entails analyzing the intervention’s benefits before its implementation, thus identifying its feasibility. Reflexive monitoring will be applied to analyze the costs and benefits of the intervention before its implementation, thereby determining its feasibility.

The intervention stakeholders will be integrated into the model phases during planning, implementation, and evaluation. A stakeholder, such as the American Diabetes Association, would be consulted for guidelines on developing the DSME intervention according to the recommended standards, thereby integrating them into the planning. Healthcare providers and diabetic patients would be integrated into the implementation and evaluation phases of the project.        

Conclusion

Diabetes is a national public health problem whose significance is felt at local, national, and global levels. Research evidence can be used to inform diabetes self-management, thus addressing the practice problem. Essentially, it is possible to summarize the evidence synthesis presented above in one statement: diabetes self-management education enhanced by healthcare technology can be used to improve diabetes self-management, prevent diabetes complications and related hospitalizations, promote desirable health outcomes, and ensure a better quality of life for diabetes patients. The normalization process theory can be used as a framework to integrate stakeholders into the practice change project.             

References

Centers for Disease Control and Prevention (2022). National Diabetes Statistics Report website. https://www.cdc.gov/diabetes/data/statistics-report/index.html

Centers for Disease Control and Prevention. (n.d.) What is Diabetes? https://www.cdc.gov/diabetes/basics/diabetes.html

Ellahham, S. (2020). Artificial intelligence: The future for diabetes care. The American Journal of Medicine, 133(8), 895–900. https://doi.org/10.1016/j.amjmed.2020.03.033

Fang, M., Ishigami, J., Echouffo-Tcheugui, J. B., Lutsey, P. L., Pankow, J. S., & Selvin, E. (2021). Diabetes and the risk of hospitalization for infection: The Atherosclerosis Risk in Communities (ARIC) study. Diabetologia, 64(11), 2458–2465. https://doi.org/10.1007/s00125-021-05522-3

George, S., Stetz, L. & Patel, M. (2019). Diabetes: The World’s Weightiest Problem. [White Paper] Aetna. https://www.aetnainternational.com/en/about-us/explore/future-health/diabetes-world-weightiest-problem.html

Hailu, F. B., Moen, A., & Hjortdahl, P. (2019). Diabetes self-management education (DSME)–Effect on knowledge, self-care behavior, and self-efficacy among type 2 diabetes patients in Ethiopia: A controlled clinical trial. Diabetes, Metabolic Syndrome, and Obesity: Targets And Therapy, 2489-2499. https://doi.org/10.2147/DMSO.S223123

Hermanns, N., Ehrmann, D., Finke‐Groene, K., & Kulzer, B. (2020). Trends in diabetes self‐management education: Where are we coming from and where are we going? A narrative review. Diabetic Medicine, 37(3), 436–447. https://doi.org/10.1111/dme.14256

Jain, S. R., Sui, Y., Ng, C. H., Chen, Z. X., Goh, L. H., & Shorey, S. (2020). Patients’ and healthcare professionals’ perspectives towards technology-assisted diabetes self-management education. A qualitative systematic review. PloS One, 15(8), e0237647. https://doi.org/10.1371/journal.pone.0237647

Khan, M. M., Roberson, S., Reid, K., Jordan, M., & Odoi, A. (2021). Geographic disparities and temporal changes in diabetes prevalence and participation in diabetes self-management education programs in Florida. Plos one, 16(7), e0254579. https://doi.org/10.1371%2Fjournal.pone.0254579

O’Connell, J. M., & Manson, S. M. (2019). Understanding the economic costs of diabetes and prediabetes and what we may learn about reducing these conditions’ health and economic burden. Diabetes Care, 42(9), 1609–1611. https://doi.org/10.2337/dci19-0017

Seboka, B. T., Yilma, T. M., & Birhanu, A. Y. (2021). Factors influencing healthcare providers’ attitude and willingness to use information technology in diabetes management. BMC Medical Informatics and Decision Making, 21(1), 1-10. https://doi.org/10.1186/s12911-021-01398-w

Standl, E., Khunti, K., Hansen, T. B., & Schnell, O. (2019). The global epidemics of diabetes in the 21st century: Current situation and perspectives. European Journal of Preventive Cardiology, 26(2_suppl), 7–14. https://doi.org/10.1177/2047487319881021

Streit, L. & Spritzler, F. (2020). [Expert’s Opinion] 11 Ways to Prevent Diabetes.  https://www.healthline.com/nutrition/prevent-diabetes

World Health Organization. (n.d.). Diabetes. https://www.who.int/health-topics/diabetes#tab=tab_1

Zheng, F., Liu, S., Liu, Y., & Deng, L. (2019). Effects of an outpatient diabetes self-management education on patients with type 2 diabetes in China: A randomized controlled trial. Journal of Diabetes Research, 2019. https://doi.org/10.1155/2019/1073131

Appendix A: Johns Hopkins Nursing Evidence-Based Practice Individual Evidence Summary Tool

Practice Question: Among Type 2 Diabetes patients, does DSME utilizing healthcare technologies, compared to routine patient education, reduce diabetes-related complications within six months?  

Date: 11th February

  Article Number    Author and Date    Evidence Type  Sample, Sample Size, SettingFindings That Help Answer the EBP Question  Observable Measures    Limitations  Evidence Level, Quality
64 (11)Fang, M., Ishigami, J., Echouffo-Tcheugui, J. B., Lutsey, P. L., Pankow, J. S., & Selvin, E. 2021Experimental research  12379 participants of the Atherosclerosis Risk in Communities (ARIC) study were used in the studyThe findings of this study are that diabetes is associated with a higher risk for infection and hospitalization. These infections may result from diabetes complications or other related comorbidities.  The ‘article’s main aim was to determine the association between diabetes and the risk of infections leading to hospitalization. It was observed that people with diabetes are more likely to be hospitalized due to infections than people without diabetes.  The definition of hospitalization for infection was not validated The association between glycemic control and infection complications was not measured There was a physician’s bias toward referring diabetes patients to the hospital due to infectionsFang et al. (2021) was appraised at Level 3 evidence with grade A quality. The study has generalizable results and the sample size is sufficient for the study design.
21(1)Seboka, B. T., Yilma, T. M., & Birhanu, A. Y. 2021Cross-sectional study  The sample contains 406 participants, with 283 nurses and 123 physicians in two teaching and referral hospitals where remote monitoring of patients had not been implemented.     The findings that address the practice problem are that care providers are willing and ready to use healthcare information technology to facilitate diabetes management.   Among the observable measures in this study is the use of structured questionnaires to collect data and descriptive statistics in the analysis. Tables and figures are also used to display the results of the attitudes and willingness of care providers to use information technology in diabetes management.  The study had two significant limitations: one, only a quantitative approach was used. Thus, the findings may lack enough strength. Second, the study was conducted; therefore, the generalizability of the findings may be limited. Seboka et al. (2021) was appraised at level 3 evidence and Grade A quality. The results are reasonable and consistent. The study is based on a comprehensive literature review.
11(1)Whittemore, R., Vilar-Compte, M., De La Cerda, S., Marron, D., Conover, R., Delvy, R., Lozano, A. M. & Pérez-Escamilla, R. 2019Qualitative Descriptive studyThe sample included 20 adults with type 2 diabetes and 19 care providers from Mexico and various clinics.       The findings contributing to addressing the evidence-based practice question include that personal challenges mentioned by the patients include inadequate social support, difficulties in lifestyle modification, and mental health issues. The system challenges identified by care providers include barriers to patient engagement, perceived quality of care, and inadequate resources.  The study aimed to identify the challenges in diabetes self-management as perceived by patients with type 2 diabetes and their care providers. Tables and figures are used to illustrate the various challenges in diabetes self-management as perceived by patients and healthcare providers.  One of the major limitations of this study is that it was confined to a single geographical setting. Although Mexico serves as a model for other low-income settings, the findings may not be representative of all vulnerable populations.Whittemore et al. (2019) was appraised at level 3 evidence. It presents a qualitative study with grade-A quality evidence. It has generalizable results and a consistent conclusion. However, the sample size and characteristics are not representative of vulnerable populations. 
1073131Zheng, F., Liu, S., Liu, Y., & Deng, L. 2019Randomized Controlled Trial (RCT)Sixty patients with type 2 diabetes. 30 were allocated to a control group and 30 to an intervention groupThe findings of this study are that diabetes self-management education effectively improves the level of self-reported self-management, psychological distress, and glycemic control in patients with type 2 diabetes.  To determine the effects of an outpatient diabetes self-management education program, two regular health education programs were provided. The observable measures included diabetes self-care activities, which were measured and recorded before and after the intervention.  Despite mentioning the effects of diabetes self-management interventions, the article does not include the effectiveness of these interventions in improving patient outcomes. The use of only two education sessions may have provided limited evidence.Zheng et al. (2019) appraised at Level 1 evidence with grade A quality. The study was unbiased, and the risk of systematic errors was minimal. The sample size is sufficient for the study design.

Attach a reference list with full citations of articles reviewed for this Practice question.

Reference List

Fang, M., Ishigami, J., Echouffo-Tcheugui, J. B., Lutsey, P. L., Pankow, J. S., & Selvin, E. (2021). Diabetes and the risk of hospitalization for infection: the Atherosclerosis Risk in Communities (ARIC) study. Diabetologia, 64(11), 2458–2465. https://doi.org/10.1037/hea0000710

Seboka, B. T., Yilma, T. M., & Birhanu, A. Y. (2021). Factors influencing healthcare providers’ attitude and willingness to use information technology in diabetes management. BMC Medical Informatics And Decision Making, 21(1), 1-10. https://doi.org/10.1186/s12911-021-01398-w

Whittemore, R., Vilar-Compte, M., De La Cerda, S., Marron, D., Conover, R., Delvy, R., Lozano, A. M. & Pérez-Escamilla, R. (2019). Challenges to diabetes self-management for adults with type 2 diabetes in low-resource settings in Mexico City: a qualitative descriptive study. International Journal For Equity In Health, 18(1), 1–10. https://doi.org/10.1186/s12939-019-1035-x

Zheng, F., Liu, S., Liu, Y., & Deng, L. (2019). Effects of an outpatient diabetes self-management education on patients with type 2 diabetes in China: a randomized controlled trial. Journal of Diabetes Research, 2019. https://doi.org/10.1155/2019/1073131