NURS 6052: Essentials of Evidence-Based Practice
Implementation of evidence-based practice (EBP) requires proper scientific research. Research theories, models, and frameworks exist to guide research and ensure outcomes are determined through consistent, verifiable, methods. Poilt and Beck (2017) assert that a reciprocal relationship exists between research and theories. The value of basing research on established theories, models, and frameworks is that replication establishes evidence which can be appraised and utilized as EBP. Once a theory has been established through research, that theory serves to provide a foundation for new methods. They also ensure that research can be replicated and subsequently used to influence nursing practice (Polit and Beck, 2017). This cycle of research based on theories and models expands and elevates nursing practice. Nursing research directly influences EBP and patient outcomes making it an invaluable tool.
I selected an article about weight loss maintenance, as this issue affects nearly every single type of patient care. This article was also interesting to me because it emphasized the importance of psychological factors in maintaining weight loss, and because psychiatric patients frequently struggle with their weight. The model that I chose was Pender’s health promotional model (HPM). Heydari and Khorashadizadeh (2014) contend that Pender’s HPM can be used in research that aims to determine effective factors or barriers in health promotion behaviors and that this model can detect the impacts of interventions on health management. Moreover, Pender’s HPM can be used as a comparison with other models and to determine the relationship or causality of variables associated with healthy behaviors (Heydari & Khorashadizadeh 2014).
Valek, Greenwald, and Lewis (2015) maintain that Pender’s HPM can guide clinical interventions to help clients maintain an ideal weight. Obesity is a growing health problem in the United States; by 2020 it is projected that 40% of the adult population will be overweight or obese. Increased weight comes with serious medical co-morbidities such as cardiovascular disease, type two diabetes, sleep apnea, and cancer. Approximately 21% of all healthcare dollars are spent on illness associated with being overweight. Consequently, only 20 to 26% of people who lose 10% or more of their body weight can maintain that loss over two years (Valek, Greenwald, & Lewis, 2015).
Using Pender’s HPM, the author’s constructed clinical interventions to help patients with weight loss maintenance (WLM). The interventions were aimed at addressing psychological factors including internal drive, ongoing self-monitoring, long-term flexibility, positive mood and emotion, appropriate goal setting, and managing external stimuli. Pender’s HPM guided the authors to develop strategies that would help improve self-esteem, foster commitment to a plan of action, manage real and perceived barriers, recognize interpersonal and situation influences, and effectively cope with stress (Valek, Greenwald, & Lewis, 2015).
Practice recommendations for WLM regarding internal drive include assessing motives for weight loss, discussing body image, promoting positive self-talk, and providing a partnership in decision making. Self-monitoring interventions include providing patients with tools to monitor diet and exercise, promoting ownership of a new lifestyle that promotes WLM, and assisting clients in finding activities that they enjoy. Providers can assess the status of weight habits and provide feedback to enhance the long term flexibility of WLM. Screening for depression and providing education on coping with stress will help patients maintain positives moods and manage their emotions. Providers should assist patients in establishing appropriate weight loss goals. Finally, clinical interventions that help patients manage external stimuli include identification of a weight-loss mentor, and assessing how patients compare their bodies to their peers (Valek, Greenwald, & Lewis, 2015).
It should be recognized that this type of research could be used to develop even more evidenced-based clinical interventions to assist patients with WLM. It could also be used to help nurse researchers design health promotion strategies that are relevant to other clinical areas such as medication compliance, preventative screenings, and smoking cessation. Pender’s HPM is highly appealing because it empowers patients to take an active role in their wellness or lack thereof. Models that focus on health promotion guide holistic care, and foster the development of preventative services rather than reactive care. I believe that we are currently involved in a pivotal moment in medicine, a paradigm shift; we are evolving our system from reactive care to preventative care. More research is needed to help facilitate such a meaningful and necessary shift, and the nursing profession is positioned to help lead the way through research and EBP.
Heydari, A., & Khorashadizadeh, F. (2014). Pender’s health promotion model in medical research. Journal of the Pakistan Medical Association,64(9).
Polit, D. F., & Beck, C. T. (2017). Nursing research generating and assessing evidence for nursing practice. Philadelphia: Wolters Kluwer.
Valek, R. M., Greenwald, B. J., & Lewis, C. C. (2015). Psychological factors associated with weight loss maintenance. Nursing Science Quarterly,28(2), 129-135. doi:10.1177/0894318415571598