DNP 816 Bipolar Patient in Er Question

DNP 816 Bipolar Patient in Er Question

DNP 816 Bipolar Patient in Er Question

1 DNP 816 Article Matrix and Analysis Northern Kentucky University Dr. DellAntonio February 14, 2021 Student Name ______Julia Johnson_________ PICO Question: P = Bipolar 1 patients in an Emergency Room setting, I = how important and effective it is to have a medical provider certified in mental health prescribe the initial dose of medication and care to these patients, C = Instead of being in the care of a medical professional who has little to no mental health experience, and lack knowledge in prescribing mood stabilizer medications, O = Reduce readmissions, promote medication and treatment compliance Search process: Multiple databases were used for the search. The articles analyzed were assessed based on the abstract, the credentials of the authors, and the criteria listed later in the paper until I identified the five articles addressed in the article matrix. Search terms: To identify articles relevant to the research, the following search words were used: Treatment of Bipolar I Disorder, direct contact with medical professionals, contact with medical physicians, interacting of bipolar patients with medical professionals. Databases: Use several medical databases to find and review research articles including PubMed, CINAHL, Cochrane Library, LILACS, and Trip Pro. Total number of articles obtained from search results: N= 15 Number of articles initially excluded based on abstract reading: N= 9 Number of articles reviewed: N= 9 Number of articles excluded based on criteria: N= 4 Inclusion Criteria: Peer review, articles in English only, Focuses on bipolar 1 Exclusion Criteria: Article published before 2016, articles in languages other than fully English 2 Number of systematic reviews or meta-analyses used in Matrix- N = 0 Repeat this table – one for each article you are review. DO NOT double space in the table Author, year; Credentials Article #1 Article Focus/Title Research Design/Interve ntion Level of Evidence Sample/# of subjects Evaluation Tool Data Collection procedure Type of Instrument Reliability and Validity Data Analysis Hendrikoff, L., Kambeitz-Ilankovic, L., Pryss, R., Senner, F., Falkai, P., Pogarell, O., & Peters, H (2018). All the authors are medical professionals working in health research institutions or hospitals in Germany. Prospective acceptance of distinct mobile mental health features in psychiatric patients and mental health professionals. Quasi-experimental research design. The research participants were expected to fill out questionnaires sent through an online link. Psychiatrists and psychotherapists around Munich were asked to distribute the questionnaire. Level III For patients from 15 psychiatric hospitals, we sent an online questionnaire to fill out. Altogether, 486 subjects anonymously selfcompleted the questionnaire.  DNP 816 Bipolar Patient in Er Question

Online links sent to hospitals were answered by 169 physicians, 128 psychologists, and 189 patients. From outpatient units/ practices, 25 psychiatrists and 29 psychologists participated. JBI checklist for a quasi-experimental study score 8/9. The questionnaire used for data collection is divided into three sections. The first section enquires about the frequency of electronic device usage, the second part of the survey asks yes or no questions on whether patients would participate in distinct eHealth features and if MHPs would support their implementation and the third part addresses patients’ view of eHealth and any issues. Questionnaire/test that included demographic information and questions addressing treatment in three dimensions; dietary adherence, compliance to medication regimen, and physical activity plan. DNP 816 Bipolar Patient in Er Question

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The study complies with the Declaration of Helsinki and received full approval from the local ethics committee. The questionnaire was created for this research study and structures to fit the needs of the study. Data were analyzed using RStudio (https://www.rstudio.com, Version3.4.3). Responses of the three groups to scaled question formats (device usage, general acceptance of eHealth) were tested for significance of group differences by nonparametric analysis of variance (Kruskal-Wallis-Test) with post-hoc Dunn’s test. Dichotomous answers (distinct features) were assessed via Pearson’s chi-squared test with post-hocchi-squared test of independence(physicians vs psychologists and MHP vs patients). The significance level was set to p < .05, corrected for multiple comparisons. For questions only addressing MHP-groups (Fig. 2D and E) Mann-Whitney-U-test for twogroup comparison was calculated. Furthermore, we performed correlation analyses (Spearman) between demographic and behavioral 3 sample characteristics, scaled questions regarding general acceptance of eHealth and the sum of supported features (SSF); p-values were computed using algorithm AS 89. Results/Theme Attributions of importance were strongly correlated with the SSF. Overall worriedness about risks of data protection was indicated and s most pronounced in patients (Fig. 2 F). However, group differences were not significant (H=3.12, p=.210) and the negative correlation with SSF was low, yet significant for MHP (driven by psychologists), not for patients. A moderate negative and positive correlation with SSF was found forage in MHP and device usage in patients, respectively. Furthermore, gained ease of clinical processes in MHP correlated negatively with age (rho=0.17, p=.004) and strongly correlated with the SSF (rho=0.53, p < .001). On the contrary, the perceived risk of commercialization was age-correlated for psychologists (rho=0.28, p=.002). Group differences were not significant (W=11600, p=.23Themes: blended educational program; improving medication adherence Discussion/ Overall, general and feature-specific acceptance did not differ to a great extent between MHP and patients. Answers indicate mixed Significance/ perspectives across all groups. In all three groups, slight majorities encourage daily reports of mental state. A higher degree of Limitations acceptance of psychotherapists compared to physicians is likely to reflect greater subjective relevance in daily practice. The same relevance could be assumed regarding monitored drug-taking that seems to be valued to a higher extent by physicians and patients than in psychotherapists. The changed setting of conventional techniques like shifting from direct face-to-face communication to video conversation was opposed only by a minority of MHP. Despite mixed positions of patients, further development and integration into regular care is demanded with adequate attention to concerns. Limitation: The results were based on self-report and were not verified objectively. Helpful/Reliabl Very helpful and valid. DNP 816 Bipolar Patient in Er Question

The study clearly shows the importance of the topic and includes relevant stakeholders in the study such as e/Compared to MHP and mental health patients. other art Compared to other articles: The findings of the study were consistent with other articles regarding proper medication for mental health patients. Author, year; Credentials, Article #2 Article Focus/Title Research Design/Interve ntion Level of Evidence Łojko, D., Owecki, M., & Suwalska, A. (2019). Lojko works in the Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland Owecki works in Department of Public Health, Chair of Social Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland, and Suwalska works in Department of Mental Health, Chair of Psychiatry, Poznan University of Medical Sciences, 61-701 Poznan, Poland. Impaired glucose metabolism in bipolar patients: the role of psychiatrists in its detection and management Randomized control trial. The Bipolar Disorder (BD) patients involved in the study had to take tests that measure glucose metabolism. Level I 4 Sample/# of subjects Evaluation Tool Data Collection procedure Type of Instrument Reliability and Validity 88 Bipolar Disorder (BD) patients who had been diagnosed with BD for more than five years and had been in an outpatient university hospital clinic were screened for the study. CASP for randomized control trial Score 10/11 Data Analysis To evaluate the normality of the distribution of the variables, the Kolmogorov-Smirnov test was applied. The socio-demographic, lifestyle, and clinical characteristics ofthesubjectswerecomparedusingtheMann-Whitneytestforcontinuousvariablesandthe χ2 test for categorical variables. Spearman’s rank correlation coefficient was used for interdependence analysis for continuous variables. Sensitivity and specificity of the TyG index were estimated as a function of the threshold used to define insulin resistance by the HOMA. The optimal value of the TyG index for insulin sensitivity cut-off point was established on a receiver operating characteristic (ROC) scatterplot. The area under the ROC curve (AUC), as a summary of the overall diagnostic accuracy of the test, was estimated. The level of statistical significance was set at p < 0.05. SPSS (IBM Corp. Released 2016. IBM SPSS Statistics for Windows, Version 24.0. IBM Corp, Armonk, NY, USA) was used for all analyses. DNP 816 Bipolar Patient in Er Question

Continuous variables are presented as mean values and standard deviation, while categorical variables are presented as a sample percentage (%). Results/Theme s Nine patients did not meet the inclusion criteria, four participants were excluded from analysis, due to missing data and three patients withdrew their consent. Five of the 88 patients had been diagnosed with T2D before the study, and in three of the 88 subjects, diabetes was detected based on the criterion of random fasting glucose level obtained by venous blood draw more than 125 mg/dL (7 mmol/dL) [47] confirmed by repeated abnormal fasting glucose level on another day. The fasting glucose test revealed T2D in three patients and impaired fasting glycemia in 20 persons. Those patients were referred to as diabetologists collaborating with our department. Assessment of insulin resistance with HOMA-IR revealed it in 51% BD patients, more than the 32% reported in the previous work, in which the same conservative cut-off point has been used [4]. More than half of IR patients had the fasting glucose result below 100 mg/dL, which suggests that a simple assessment of fasting glucose is not sufficient to detect impaired glucose metabolism. In our BD group, the TyG index significantly correlated with the HOMA-IR results showing the usefulness of recognizing Insulin Resistance among BD subjects. Limitation: The sample was derived from a tertiary referral center and it might represent a population of patients with more severe BD Discussion/ Significance/ Limitations The data was collected using a semi-structured questionnaire. A semi-structured questionnaire developed by authors of the study was used, including socio-demographic information data, information on educational status (number of years of education), living alone or with family, concomitant diseases, and lifestyle. The study was conducted following the Helsinki Declaration and the protocol was approved by the Ethics Committee of Poznan University of Medical Sciences. All subjects gave their written consent after receiving a full explanation of the nature and procedures of the study. 5 who might have higher rates of impaired glucose metabolism. Helpful/Reliabl The study showed the need for medical professionals to monitor BD patients directly to ensure they are diagnosed and treated e/Compared to correctly. other art The findings of the study are in line with other studies conducted on the topic.DNP 816 Bipolar Patient in Er Question

Author, year; Credentials, Article #3 Article Focus/Title Research Design/Interve ntion Level of Evidence Sample/# of subjects Evaluation Tool Data Collection procedure Type of Instrument Reliability and Validity Data Analysis Sheila G. Mauldin, MNM; Dawn Morton-Rias, EdD, PA-C; Grady C. Barnhill, Med; Andrzej Kozikowski, Ph.D.; Roderick S. Hooker, Ph.D., MBA, PA (2020). All the authors are medical professionals who have an active medical license. Results/Theme s Discussion/ The median age of responding PAs was 38 years, and 68% were women. One-fifth (22%) of all PAs identified their medical role as primary care. The remaining 78% reported practicing in a wide variety of specialties, of which 2% were in psychiatry. The frequency of PA encounters with mental health conditions across the spectrum of medical and surgical specialties in their practice The role of PAs in providing mental health care. Randomized control trials. The researchers sent a survey to physician assistants (PAs) who completed the 90-minute survey. Level I A link to the survey was sent to 93,365 PAs with a valid email address; 15,771 PAs completed the 90-minute survey for a 16.9% response rate. CASP for randomized control trial Score 11/11 The dataset from the National Commission on Certification of Physician Assistants’ (NCCPA) national practice analysis was used to assess the frequency and types of mental health conditions that PAs in different medical and surgical specialties encounter in their practice. NCCPA developed the survey instrument through an iterative process, relying on clinical PA and psychometrician subject matter experts to maximize content validity. NCCPA developed the survey instrument through an iterative process, relying on clinical PA and psychometrician subject matter experts to maximize content validity. Descriptive statistics including median and mean for continuous variables and frequency and percentage for categorical variables were calculated. Demographic characteristics of the respondents mirrored those found in the NCCPA PA Practice Profi le, and because the sample was representative of the population of certified PAs, weighting was not conducted. 6 was explored using unique data from NCCPA’s practice analysis. The data provide insight into how PAs evaluated the criticality and frequency of specifi c psychiatric skills. The effect of these findings is that almost all clinically active PAs reported encountering behavioral conditions and mental health disorders regardless of medical and surgical specialty Helpful/Reliabl Helpful but cautious, the potential bias negatively impacts the validity and the reliability of the study. A clear statement of findings. e/Compared to The importance of the topic was established. Rigorous data anal other art Consistent findings regarding mental health care. DNP 816 Bipolar Patient in Er Question