NURS FPX 4025 Assessment 4 Presenting Your PICO(T) Process Findings to Your Professional Peers

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Capella university

NURS-FPX4025 Research and Evidence-Based Decision Making

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Presenting Your PICO(T) Process Findings to Your Professional Peers

Chronic Obstructive Pulmonary Disease (COPD) is a long-term respiratory condition that progressively limits airflow and significantly reduces patients’ ability to breathe comfortably. It is one of the most prevalent chronic illnesses worldwide and is closely associated with cigarette smoking, the leading risk factor. Although quitting smoking is proven to slow the disease’s progression and improve overall health, many individuals with COPD face difficulties due to strong nicotine dependence, stress, and inadequate support networks (Choi et al., 2021).

This discussion examines whether structured smoking cessation programs are more beneficial than traditional counseling in enabling COPD patients to quit smoking and enhance lung function over a six-month period. Addressing this clinical question is essential because effective, evidence-based approaches not only improve individual health outcomes but also reduce the frequency of hospital admissions and lower healthcare expenditures.

Diagnosis: Outcomes, Risks, and Complications

COPD is primarily defined by persistent breathing difficulties and obstruction of the airways. The condition is most commonly caused by prolonged exposure to harmful irritants, especially tobacco smoke. In the United States, more than 14 million individuals live with COPD, experiencing symptoms such as chronic cough, dyspnea, wheezing, and recurrent respiratory infections (Boers et al., 2023).

As COPD advances, lung function continues to decline, making daily activities increasingly difficult and negatively affecting quality of life. Patients may suffer frequent exacerbations, which often lead to emergency visits and higher mortality risks. COPD is also linked to other medical conditions, including heart disease, osteoporosis, depression, and muscle weakness, further complicating patient care.

In severe stages, individuals may experience chronic respiratory failure, requiring oxygen therapy or mechanical ventilation (American Lung Association [ALA], 2024). Continued smoking accelerates the decline in pulmonary function, heightens the risk of hospitalization, and increases premature death. Research shows that quitting smoking through structured programs is critical in slowing the disease and improving long-term outcomes.

Research Question Using PICO(T) Criteria

Research Question:
For adults with COPD (P), does participating in a structured smoking cessation program that combines behavioral support and pharmacological treatment (I), compared with routine counseling (C), improve smoking cessation rates and pulmonary function (O) within six months (T)?

PICO(T) Framework

PICO(T) Component	Explanation
Population (P)	Adults diagnosed with COPD, since smoking is a primary cause and quitting is vital for managing disease progression.
Intervention (I)	Structured smoking cessation programs using behavioral counseling along with medications such as Nicotine Replacement Therapy (NRT), bupropion, or varenicline.
Comparison (C)	Standard cessation counseling, often involving brief advice or educational handouts.
Outcome (O)	Higher quit rates and better lung function, measured by sustained abstinence and FEV1%.
Time (T)	Six months, chosen because this period is a strong predictor of long-term smoking cessation success.

This model provides clarity and precision, ensuring that the research question is measurable and clinically meaningful (Onwuzo et al., 2024).

Evidence Summary from Peer-Reviewed Studies

A review of recent studies demonstrates that structured smoking cessation interventions consistently outperform standard counseling.

• Wang et al. (2024) analyzed 11 clinical trials with over 13,000 participants. Results showed improved lung function, better exercise endurance, and reduced mortality for patients in structured programs.
• Han et al. (2023) conducted a randomized controlled trial, revealing that combining behavioral methods such as CBT with medications significantly increased quit rates compared to conventional counseling.
• Fu et al. (2022) emphasized that evidence-based frameworks like the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model are valuable for systematically incorporating cessation strategies into healthcare practice.
• Hu et al. (2021) found that six-month abstinence is a reliable marker of long-term success, with nearly 28% of participants remaining smoke-free.

Together, these findings confirm that comprehensive, multi-component smoking cessation programs provide stronger outcomes than brief counseling interventions.

Answer to the PICO(T) Question Based on Evidence

The collective evidence indicates that structured smoking cessation programs are significantly more effective than traditional counseling for COPD patients. These programs not only increase long-term smoking abstinence but also contribute to better lung function and reduced risk of death (Wang et al., 2024; Han et al., 2023).

Interventions that combine behavioral support with pharmacological aids provide a more holistic approach, tackling both psychological and physical aspects of nicotine addiction. Evidence-based practice models like JHNEBP enhance the ability of clinicians to integrate these interventions effectively into care systems (Fu et al., 2022). While personal and social factors may affect individual results, six-month outcomes remain a reliable measure for evaluating intervention effectiveness (Hu et al., 2021).

Key Evidence-Based Care Recommendations

Evidence supports a structured approach to smoking cessation care for COPD patients, including:

Patient Assessment

• Collect detailed smoking histories, assess nicotine dependence, and evaluate readiness to quit.
• Identify potential barriers, including mental health challenges or lack of social support.

Individualized Treatment Plan

• Implement structured programs combining behavioral therapy (e.g., CBT, motivational interviewing) with medication support (NRT, varenicline, bupropion).

Consistent Follow-Up

• Schedule follow-ups at one, three, and six months to encourage progress, address challenges, and prevent relapse.

Patient Education

• Provide information on how quitting smoking improves lung function and overall health.
• Offer training in self-management strategies for COPD symptoms.

Team-Based Care

• Engage multidisciplinary professionals, including nurses, respiratory specialists, and primary care providers, to deliver coordinated support (Choi et al., 2021).

Structured Frameworks

• Use evidence-based frameworks like JHNEBP to guide systematic integration of research into practice.

Through these measures, healthcare providers can enhance cessation outcomes, reduce disease complications, and support patients in achieving long-term wellness.

Conclusion

COPD is a progressive respiratory illness strongly associated with smoking. Structured smoking cessation programs that combine behavioral support with pharmacological therapies are more effective than standard counseling alone. Evidence from clinical research and practice frameworks supports these programs as the most effective approach for COPD management. Implementing such strategies not only improves health outcomes and quality of life but also reduces the burden of COPD on healthcare systems.

References

American Lung Association (ALA). (2024). Learn about COPD | American Lung Association. https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/learn-about-copd

Boers, E., Barrett, M., Su, J. G., Benjafield, A. V., Sinha, S., Kaye, L., Zar, H. J., Vuong, V., Tellez, D., Gondalia, R., Rice, M. B., Nunez, C. M., Wedzicha, J. A., & Malhotra, A. (2023). Global burden of chronic obstructive pulmonary disease through 2050. JAMA Network Open, 6(12), e2346598. https://doi.org/10.1001/jamanetworkopen.2023.46598

Choi, H. K., Vargas, J. A., Lin, C., & Singrey, A. (2021). The current state of tobacco cessation treatment. Cleveland Clinic Journal of Medicine, 88(7), 393–404. https://doi.org/10.3949/ccjm.88a.20099

NURS FPX 4025 Assessment 4 Presenting Your PICO(T) Process Findings to Your Professional Peers

Fu, Y., Chapman, E. J., Boland, A. C., & Bennett, M. I. (2022). Evidence-based management approaches for patients with severe chronic obstructive pulmonary disease (COPD): A practice review. Palliative Medicine, 36(5), 770–782. https://doi.org/10.1177/02692163221079697

Han, M. K., Fu, Y., Ji, Q., Duan, X., & Fang, X. (2023). The effectiveness of theory-based smoking cessation interventions in patients with chronic obstructive pulmonary disease: A meta-analysis. BMC Public Health, 23(1). https://doi.org/10.1186/s12889-023-16441-w

Hu, Y., Xie, J., Chang, X., Chen, J., Wang, W., Zhang, L., Zhong, R., Chen, O., Yu, X., & Zou, Y. (2021). Characteristics and predictors of abstinence among smokers of a smoking cessation clinic in Hunan, China. Frontiers in Public Health, 9, 615817. https://doi.org/10.3389/fpubh.2021.615817

Onwuzo, C. N., Olukorode, J., Sange, W., Orimoloye, D. A., Udojike, C., Omoragbon, L., Hassan, A. E., Falade, D. M., Omiko, R., Odunaike, O. S., Momoh, P. A. A., Addeh, E., Onwuzo, S., & Erameh, U. J. (2024). A review of smoking cessation interventions: Efficacy, strategies for implementation, and future directions. Cureus, 16(1). https://doi.org/10.7759/cureus.52102

NURS FPX 4025 Assessment 4 Presenting Your PICO(T) Process Findings to Your Professional Peers

Wang, Z., Qiu, Y., Ji, X., & Dong, L. (2024). Effects of smoking cessation on individuals with COPD: A systematic review and meta-analysis. Frontiers in Public Health, 12. https://doi.org/10.3389/fpubh.2024.1433269