The purpose of this assignment is to refine the PICOT question you developed in the discussion forum this week and begin evaluating literature that you will use in subsequent weeks to write your research paper
The purpose of this assignment is to refine the PICOT question you developed in the discussion forum this week and begin evaluating literature that you will use in subsequent weeks to write your research paper.
Use the “Literature Evaluation Table” to complete this assignment. Prior to starting the “Literature Evaluation Table,” complete the following:
- Review the feedback you have received in the discussion forum related to your PICOT question so far. Make any necessary edits to your PICOT question.
- Conduct a literature search to locate four research articles focused on your selected nursing practice problem of interest. Note: This literature search should include two quantitative and two qualitative, peer-reviewed, primary research articles to support your nursing practice problem. A mixed methods article can qualify towards meeting a qualitative or quantitative methodology. The two articles identified in Topic 1 DQ 2 can be used should you still find them relevant to your PICOT question.
Articles must be published within the past 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
The PICOT question and four peer-reviewed research articles you chose will be utilized for subsequent assignments.
Note: For best search results, do not include the words qualitative and quantitative in your search terms. Do include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic reviews, literature reviews, and metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignment.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.
Sample Expert Answer
NRS-445 Topic 1: Literature Evaluation Table
Student Name:
Faculty Name:
Background of Nursing Practice Problem:
Asthma is one of the most common chronic conditions in children and is a leading cause of hospital admissions and readmissions. Effective management at home relies heavily on caregivers, who are responsible for recognizing symptoms, administering medications, and avoiding environmental triggers. However, caregivers often face significant challenges in managing pediatric asthma, including limited knowledge of treatment plans, uncertainty in identifying early warning signs, and difficulties maintaining adherence, all of which contribute to higher readmission rates (Jones et al., 2022).
Traditional discharge instructions are usually brief and may not provide caregivers with the skills or confidence needed to manage asthma effectively after the child leaves the hospital. Nurse-led self-management education programs address this gap by providing structured, tailored instruction to caregivers, ensuring they understand medication use, inhaler techniques, and strategies for monitoring symptoms. Evidence shows that such interventions, including web-based education, improve caregiver confidence, knowledge, and engagement, leading to better home management and reduced hospital utilization (Ng et al., & Cheng, 2021).
By equipping caregivers with practical tools and ongoing support, nurse-led education has the potential to significantly reduce 30-day readmission rates and improve outcomes for children with asthma.
PICO(T) Question: In caregivers of children with asthma (P), how does a nurse-led self-management education program (I) compared to usual discharge instructions (C) affect 30-day hospital readmission rates (O) within one-month post-discharge (T)?
| PICO(T) Question Template | ||
| P | Population | Caregivers of children with asthma |
| I | Intervention | A nurse-led self-management education program |
| C | Comparison | Usual discharge instructions |
| O | Outcome | 30-day hospital readmission rates |
| T | Timeline (optional) | Within one-month post-discharge |
| Intervention | ||
| The intervention is a nurse-led asthma self-management education program delivered to caregivers before hospital discharge. It includes hands-on training in correct inhaler and spacer use, recognition of early asthma symptoms, personalized action plans, trigger avoidance strategies, and follow-up support through phone calls or digital platforms to reinforce learning and ensure adherence. | ||
| Problem Statement | ||
| It is not known if the implementation of a nurse-led self-management education program (I) would impact 30-day hospital readmission rates (O) among caregivers of children with asthma (P) within one month post-discharge (T). | ||
| Criteria | Article 1 | Article 2 | Article 3 | Article 4 |
| APA Reference
(include the GCU permalink or working link used to access the article) |
Kassa, E., Kebede, R. A., & Habte, B. M. (2022). Perceptions towards childhood asthma and barriers to its management among patients, caregivers and healthcare providers: a qualitative study from Ethiopia. BMC Pulmonary Medicine, 22(1), 184. https://doi.org/10.1186/s12890-022-01984-2 | Ng, J. S. K., Chau, J. P. C., Chan, A. W. K., Lui, J. K. C., & Cheng, J. W. C. H. (2021). A nurse-led web-based home asthma education program for children and their families: A randomized controlled trial. Journal of Pediatric Nursing, 59(1), 158–163. https://doi.org/10.1016/j.pedn.2021.04.014
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Radhakrishnan, D., Higginson, A., Thipse, M., Tessier, M., & Radhakrishnan, A. (2022). Optimizing pediatric asthma education using virtual platforms during the COVID-19 pandemic. Allergy, Asthma & Clinical Immunology, 18(1), 72. https://doi.org/10.1186/s13223-022-00713-y | Thach, C., Lafont, C., Epaud, R., Tahiri, K., Sauvage, F., Sagorin, V., Sérabian, V., & Delestrain, C. (2024). Effectiveness of pediatric asthma education program in the context of a general hospital in France: A retrospective real-life study. Heliyon, 10(15), e35356. https://doi.org/10.1016/j.heliyon.2024.e35356
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| Purpose/Aim of Study | “The aim of the present study was therefore to explore the perceptions of the children with asthma, their caregivers and their healthcare providers towards asthma and barriers to long term childhood asthma management in an institutional setting in Addis Ababa, Ethiopia.” | “This study aims to review existing evidence to allow for the development of a Web-based Home Asthma Education Program (WB-HAEP) for local asthmatic children and their parents, and to evaluate its effectiveness in enhancing their knowledge, attitude and practice, minimizing unscheduled visits and reducing hospital readmissions.” | The study “compared patient and caregiver knowledge and confidence for managing asthma, and participant experiences when comprehensive asthma education was delivered in person versus in the virtual setting.” | “To assess the feasibility and effectiveness of a pediatric asthma education program delivered in the context of a French suburban general hospital.” |
| Research question(s) | What are the perceptions of children with asthma, their caregivers, and their healthcare providers towards asthma, and what barriers affect long-term childhood asthma management in Addis Ababa, Ethiopia?
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Does a nurse-led web-based home asthma education program improve caregivers’ knowledge, attitudes, and practices regarding asthma management?
Does the program reduce unscheduled hospital visits and readmissions among children with asthma?
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Is virtual asthma education as effective as in-person education in improving patient and caregiver knowledge and confidence in managing asthma? | Is a pediatric asthma education program feasible and effective when delivered in the context of a French suburban general hospital?
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| Design
Is the article qualitative, quantitative, or mixed methods? Explain how you determined it was this type of research design. |
The article uses a qualitative design. This is clear because it employed in-depth individual interviews, focused on exploring perceptions and experiences of children, caregivers, and healthcare providers, and used thematic analysis for data interpretation. These characteristics align with qualitative research, which emphasizes understanding meanings rather than measuring variables.
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The article is quantitative because it employed a two-arm randomized controlled trial, used measurable outcomes such as knowledge, attitudes, practices, and hospital visits, and applied statistical analysis (p-values, Cohen’s d) to evaluate intervention effectiveness objectively.
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The article used a mixed methods design. Quantitative surveys measured knowledge, confidence, and satisfaction, summarized descriptively, while qualitative interviews explored participant experiences and themes. Combining numerical data with narrative feedback allowed comparison of in-person versus virtual asthma education, demonstrating effectiveness and participant preferences across both delivery formats. | The article uses a quantitative design, specifically a retrospective observational study. It analyzes numerical data from medical records of 262 children, comparing outcomes across different asthma education groups. No qualitative interviews or mixed-method integration were used; instead, statistical comparisons (e.g., percentages, p-values) determined effectiveness and feasibility of the program. |
| Setting
(Where did the study take place? What type of setting – inpatient, outpatient, etc.?) |
The study was conducted at Tikur Anbessa Specialized Hospital and St. Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia. Both are public tertiary hospitals running outpatient pediatric pulmonary clinics. These clinics provide follow-up care for children with asthma, offering appointments based on asthma control levels. | The study was conducted in a public hospital in Hong Kong, specifically within an acute pediatric unit and pediatric respirology training center. It involved inpatient children admitted with asthma exacerbations and their parents, with follow-ups continuing after discharge through web-based and home-based education interventions. | The study took place in a French suburban general hospital (Melun, Île-de-France), specifically within an outpatient pediatric setting where children received asthma education and follow-up care.
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| Sample
(Number and characteristics of participants) |
The study involved 23 children with asthma aged 8–15 years, each paired with a caregiver, totaling 46 participants, plus eight healthcare providers (physicians, nurses, and pharmacists). Participants were purposively selected for diversity in asthma severity, residence, and experiences, ensuring rich perspectives on barriers and perceptions in asthma management. | The sample included 112 child-parent dyads. Children were aged 4–11 years with a confirmed asthma diagnosis and communicable in Cantonese, admitted for asthma exacerbations. Parents served as caregivers. Exclusion criteria ruled out children with other chronic lung diseases, developmental delays, or prior participation in similar asthma education studies. | The sample included 100 patients/caregivers, with 52 attending in-person and 48 virtually. The mean patient age was 6.7 years (range 1.2–17.0). Caregivers varied in gender, and participants were randomly selected for monthly semi-structured interviews, ensuring representation of families receiving comprehensive asthma education in both settings. | The study included 262 pediatric patients with asthma, with a median age of 4.5 years. Most participants received some form of asthma education: 36 had minimal education, 155 an unstructured program, and 71 a structured program. Data reflected their management practices, disease knowledge, lung function, allergy testing, and hospitalizations.
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| Methods
Interventions/Instruments |
Data were collected using semi-structured interview guides adapted from similar studies and informed by Kleinman’s explanatory model and Horne’s necessity–concerns model. Face-to-face interviews, lasting 18–40 minutes, explored perceptions, adherence, barriers, and experiences with asthma management. Interviews were audio-recorded, supported by observation field notes, and analyzed thematically for emerging patterns.
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The intervention group received a nurse-led web-based asthma education program (WB-HAEP) comprising an animated video, inhaler demonstration video, web-based games, and a family-centered discussion session. Instruments included the Knowledge, Attitude, and Practice Questionnaire, Childhood Asthma Control Test, and Venham Picture Test to assess caregiver knowledge and children’s asthma control and anxiety.
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Interventions included comprehensive asthma education delivered by certified asthma educators, covering asthma pathophysiology, symptoms, triggers, medication adherence, and personalized action plans, provided in-person or virtually via Zoom. Instruments consisted of semi-structured telephone interviews with scripted closed-ended Likert-scale survey questions and open-ended questions, capturing both quantitative outcomes and qualitative feedback on experiences. | The study employed a retrospective descriptive design using medical records of children under 18 with asthma in Melun, France. Interventions included minimal, unstructured, or structured asthma education programs. Instruments involved questionnaires, skill assessment grids, inhaler technique evaluations, and medical data. Statistical analyses (chi-square, Kruskal-Wallis, logistic regression) measured program effectiveness.
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| Analysis
How were the data that were collected analyzed? |
Data were transcribed verbatim, translated into English, and independently coded by two researchers. Using Kleinman’s explanatory model and the necessity–concerns model, themes and subthemes were developed, capturing patterns, relationships, and emerging ideas through descriptive qualitative thematic analysis.
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Data were analyzed using SPSS 24.0. Baseline equivalence was tested with t-tests, Chi-square, or Fisher’s exact tests. Outcomes were compared using intention-to-treat principles and generalized estimating equations, with p-values <0.05 considered significant and effect sizes calculated using Cohen’s d.
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Data were analyzed using descriptive statistics for demographics and Likert-scale survey responses, while qualitative interview data were transcribed, coded, and thematically analyzed independently by two researchers before consensus. | The data were analyzed using descriptive and inferential statistics. Categorical variables were summarized as numbers and percentages, while quantitative variables were reported as medians with interquartile ranges. Group comparisons used chi-square or Fisher’s exact tests for categorical data, and Kruskal–Wallis tests for non-normally distributed continuous data. Logistic regression adjusted for age and sex. |
| Outcomes/key findings of the study and implications for nursing practice (Summary of study results) | The study found that children with asthma and their caregivers had low biomedical knowledge, faced emotional, physical, and social burdens, and struggled with adherence to inhaled corticosteroids due to fears, misconceptions, and poor access. For nursing practice, this underscores the need for culturally sensitive education, psychosocial support, and improved guideline-based care.
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The study demonstrated that a nurse-led web-based asthma education program significantly improved caregivers’ knowledge, attitudes, and practices, reduced children’s unscheduled hospital visits and readmissions, and lowered inhaler-related anxiety. These findings highlight the effectiveness of family-centered, technology-supported education in enhancing asthma management and support its integration into nursing practice for chronic disease care. | The study found that virtual and in-person asthma education were equally effective in improving caregiver/patient knowledge and confidence. Most participants preferred virtual sessions, citing safety, convenience, and accessibility. For nursing practice, integrating virtual education enhances patient reach, supports family involvement, reduces barriers to care, and maintains high-quality asthma self-management education. | The study found that structured asthma education improved children’s and caregivers’ knowledge, treatment adherence, and action plan use, while reducing hospitalizations and emergency visits compared to minimal education. For nursing, this highlights the vital role of structured education and follow-up in chronic disease management, empowering families and enhancing patient outcomes. |
| Recommendations of the researcher | The researchers recommend implementing pediatric asthma guidelines, providing culturally sensitive education, strengthening chronic care models, addressing psychosocial needs, and improving access and affordability of essential medications to enhance adherence and optimize childhood asthma management outcomes. | The researchers recommended expanding nurse-led web-based asthma education programs, integrating multimedia and gamification, and exploring mobile application delivery to strengthen caregiver knowledge, improve self-management, enhance adherence, and reduce hospital visits for children with asthma. | Researchers recommend continuing both virtual and in-person asthma education, expanding virtual sessions for broader reach, while ensuring access for families with limited internet, to maintain equity, personalization, and high-quality asthma self-management education. | The researchers recommend expanding access to structured asthma education programs in regional hospitals, ensuring multidisciplinary involvement, and integrating caregiver participation to enhance disease knowledge, promote self-management, and reduce acute asthma-related interventions. |
| Explain how this article supports your proposed PICO(T) question. | This article supports the PICO(T) by highlighting caregivers’ low asthma knowledge, poor adherence, and limited education from providers, reinforcing the need for structured nurse-led self-management education to improve outcomes and reduce readmissions. | This article supports the PICO(T) by showing that nurse-led asthma education improved caregiver knowledge and reduced children’s hospital readmissions, demonstrating its effectiveness compared to usual discharge instructions within the post-discharge period. | This article supports the PICOT by showing that nurse-led asthma education improves caregiver knowledge and confidence, suggesting structured education interventions may reduce readmissions compared to standard discharge instructions within one month. | This article supports the PICO(T) by showing that structured asthma education improves knowledge and reduces acute interventions, suggesting nurse-led self-management programs could lower hospital readmissions compared to standard discharge instructions.
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References
Jones, R., Turner, B., Perera, P., Hiscock, H., & Chen, K. (2022). Understanding caregiver perspectives on challenges and solutions to pediatric asthma care for children with a previous hospital admission: A multi-site qualitative study. The Journal of Asthma: official journal of the Association for the Care of Asthma, 59(10), 1973–1980. https://doi.org/10.1080/02770903.2021.1984528
Kassa, E., Kebede, R. A., & Habte, B. M. (2022). Perceptions towards childhood asthma and barriers to its management among patients, caregivers and healthcare providers: a qualitative study from Ethiopia. BMC Pulmonary Medicine, 22(1), 184. https://doi.org/10.1186/s12890-022-01984-2
Ng, J. S. K., Chau, J. P. C., Chan, A. W. K., Lui, J. K. C., & Cheng, J. W. C. H. (2021). A nurse-led web-based home asthma education program for children and their families: A randomized controlled trial. Journal of Pediatric Nursing, 59(1), 158–163. https://doi.org/10.1016/j.pedn.2021.04.014
Thach, C., Lafont, C., Epaud, R., Tahiri, K., Sauvage, F., Sagorin, V., Sérabian, V., & Delestrain, C. (2024). Effectiveness of pediatric asthma education program in the context of a general hospital in France: A retrospective real-life study. Heliyon, 10(15), e35356. https://doi.org/10.1016/j.heliyon.2024.e35356
