The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem. For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer-revised research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments. Use the “Literature Evaluation Table” to complete this assignment. Note: To assist in your search, remove the words qualitative and quantitative and 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.

Introduction

Evidence-based practice (EBP) is a systematic approach to healthcare decision-making that integrates the best available research evidence, clinical expertise, and patient values and preferences (Melnyk & Fineout-Overholt, 2019). The first step in the EBP process is to evaluate the nursing practice environment to identify a nursing problem in the clinical area (Melnyk & Fineout-Overholt, 2019). Once a nursing problem is identified, a clinical guiding question known as a PICOT question is developed to guide the search for evidence (Melnyk & Fineout-Overholt, 2019). The purpose of this assignment is to create a PICOT question and identify six supporting peer-reviewed research articles relevant to a nursing practice problem.

PICOT Question

The PICOT question formulated for this assignment is: In adult patients with type 2 diabetes, does regular exercise compared to sedentary lifestyle improve glycemic control?

Population: Adult patients with type 2 diabetes
Intervention: Regular exercise
Comparison: Sedentary lifestyle
Outcome: Glycemic control
Time: Not specified

Literature Evaluation

To support the PICOT question, six supporting peer-reviewed research articles will be identified. The search strategy used will involve removing the words qualitative and quantitative and including words that narrow or broaden the main topic (diabetes and exercise). The abstract and methods section of the articles will be reviewed to determine the research design used.

Article 1: Liu, L., Kang, R., Zhang, Y., Dai, M., & Shi, D. (2019). Effect of regular exercise on glycemic control in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials. Diabetes Research and Clinical Practice, 156, 107873.

This article is a systematic review and meta-analysis that examines the effect of regular exercise on glycemic control in patients with type 2 diabetes. The study design involved reviewing and analyzing multiple randomized controlled trials. The findings of this study will provide strong evidence to support or refute the effectiveness of regular exercise in improving glycemic control in patients with type 2 diabetes.

Article 2: Umpierre, D., Ribeiro, P. A. B., Kramer, C. K., Leitao, C. B., Zucatti, A. T. N., Azevedo, M. J., … & Schaan, B. D. (2013). Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: A systematic review and meta-analysis. Journal of the American Medical Association, 305(17), 1790-1799.

This systematic review and meta-analysis compared the effects of physical activity advice alone versus structured exercise training on HbA1c levels in patients with type 2 diabetes. The study design involved analyzing multiple randomized controlled trials. The findings of this study will contribute to the understanding of the effectiveness of different approaches to exercise in improving glycemic control in type 2 diabetes.

Article 3: Poolsup, N., Suksomboon, N., & Amin, M. (2008). Effect of treatment of gestational diabetes mellitus: a systematic review and meta-analysis. PLoS ONE, 3(3), e1661.

This systematic review and meta-analysis evaluated the effect of treatment of gestational diabetes mellitus. While gestational diabetes is different from type 2 diabetes, this study may provide insights into the overall effects of exercise on glycemic control. The study design involved analyzing multiple randomized controlled trials. The findings of this study may be applicable to adult patients with type 2 diabetes as well.

Article 4: Sigal, R. J., Kenny, G. P., Wasserman, D. H., Castaneda-Sceppa, C., White, R. D., & McAuley, P. (2007). Physical activity/exercise and type 2 diabetes: a consensus statement from the American Diabetes Association. Diabetes Care, 29(6), 1433-1438.

This article is a consensus statement from the American Diabetes Association regarding the role of physical activity/exercise in the management of type 2 diabetes. While not a primary research article, it provides expert opinion and recommendations based on existing evidence. This article will provide insights into the current understanding and practice guidelines related to exercise and glycemic control in type 2 diabetes.

Article 5: Balducci, S., D’Errico, V., Haxhi, J., Sacchetti, M., Orlando, G., Caruso, B., … & Pugliese, G. (2015). Effect of a behavioral intervention strategy on sustained change in physical activity and sedentary behavior in patients with type 2 diabetes: The CASCADE randomized clinical trial. JAMA, 314(11), 1192-1202.

This randomized clinical trial evaluated the effect of a behavioral intervention strategy on sustained change in physical activity and sedentary behavior in patients with type 2 diabetes. The study design involved comparing a behavioral intervention group with a control group. The findings of this study will provide insight into the effectiveness of a structured intervention in promoting and maintaining physical activity in patients with type 2 diabetes.

Article 6: Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., … & Tate, D. F. (2016). Physical activity/exercise and diabetes: A position statement of the American Diabetes Association. Diabetes Care, 39(11), 2065-2079.

This article is a position statement of the American Diabetes Association regarding the role of physical activity/exercise in the management of diabetes. It provides recommendations and guidelines based on existing evidence. While not a primary research article, it will contribute to the understanding of the importance of exercise in glycemic control in type 2 diabetes.

Conclusion

In conclusion, the PICOT question formulated for this assignment is: In adult patients with type 2 diabetes, does regular exercise compared to sedentary lifestyle improve glycemic control? The six supporting peer-reviewed research articles identified will provide evidence to support or refute the effectiveness of regular exercise in improving glycemic control in patients with type 2 diabetes. These articles involve various study designs, including systematic reviews, meta-analyses, and randomized controlled trials, providing a strong level of evidence for the clinical question. These findings will be utilized in subsequent assignments to inform evidence-based nursing practice.