Chronic Multi-Symptom Illness Essay

PICOT (Population/Problem, Intervention, Comparison, Outcome, and Time to achieve the outcome) is a method that helps clarify the qualities needed to create a good question out of a practice issue or problem affecting the population of focus. Additionally, the information derived from a good PICOT makes it easier to perform a literature search in order to find translational research sources that can be used to address the clinical problem.

Use a national, state or local population health care database to research indicators of disparity. Choose a mortality/morbidity indicator to identify a clinical problem or issue that you want to explore pertaining to a population of focus. Use this indicator to begin to formulate a PICOT and conduct research on the population.

PICOT: Could providing monthly physical assessments, and bi-weekly group bereavement meetings during active-duty deployment decrease the number of military veterans with CMI (chronic multisymptomatic illnesses) within a five-year time span?

Write a 750-1,000-word paper that analyzes your research and focuses on the population you have chosen. Describe the population\'s demographics and health concerns, and explain how nursing science, health determinants, and epidemiologic, genomic, and genetic data may impact population health management for the selected population. Provide an overview of a potential solution for solving the health issue related to your population and the intended PICOT statement. Describe how the solution incorporates health policies and goals that support health care equity for the population of focus.

You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

No abstract required, rubric will be uploaded.

The Practice problem of Chronic Multi-Symptom Illness or CMI in Veterans in the United States: A Clinical Inquiry Using the PICOT Model

In the course of nursing practice, there are some clinical problems that the RN nurse or APRN realizes are more prevalent in a particular population of people with specific characteristics. These clinical problems are solvable, but require evidence-based scientific interventions that have proven efficacy. This evidence in support of the efficacy of interventions comes from scholarly literature that is recent and peer-reviewed. The process of getting this evidence to inform practice change is referred to as clinical inquiry. Chronic Multi-Symptom Illness Essay.  The PICOT (population/ problem, intervention, comparison, outcome, and time-frame) model facilitates clinical inquiry because it allows the practice problem and its intended solution to be put in question from and used as a guide for searching evidence (Melnyk & Fineout-Overholt, 2019). The purpose of this paper is to outline the clinical inquiry into the clinical practice problem of chronic multi-symptom illness (CMI) among Veterans in the US.

The Population’s Demographic Characteristics and Health Concerns

In the latest US census results released in the year 2018, the number of US Veterans stood at 18 million. When compared to census results from previous years, it was clear that the population of Veterans who are still alive is diminishing. For instance, the population of Veterans was 26.4 million in the year 2000. In that last census, too; the median age of all Veterans was found to be 65 years and women made up 9% of all the Veterans. Interestingly, the data available shows that even though the number of Veterans is decreasing; that of women Veterans is steadily increasing (USCB, 2020).

At a median age of 65 years, most of the Veterans firmly fall under the geriatric population of adults. This has implications in healthcare with regard to not only access, but also the cost. By virtue of being elderly, most Veterans will be suffering from multiple comorbidities meaning that they will always be on medications. They will also be expected to suffer from some mental health conditions related to old age, particularly neurocognitive disorders such as dementia and Alzheimer’s disease (Sadock et al., 2015). It would also not be clinically far-fetched to surmise that most of the Veterans are expected to be suffering from posttraumatic stress disorder or PTSD (Reisman, 2016). Chronic Multi-Symptom Illness Essay. Veterans are expected to also be at an increased risk of suffering unintentional falls either at home or in a healthcare setting (Kojima et al., 2015).

ORDER A PLAGIARISM -FREE PAPER NOW

One particular health concern has however caused quite some concern with regard to Veteran wellbeing. It is the presentation of pain that cannot be attributed to any physical or psychiatric condition. Scholarly evidence demonstrates that this symptom belongs to a nonspecific collection of symptoms seen in Veterans and given the diagnosis of chronic multisymptom illness or CMI (McAndrew et al., 2016). Characteristically, these symptoms cannot be explained by pre-deployment illnesses or even post-deployment PTSD. What is of concern, however, is that over 90% of the Veterans assessed conform to the diagnostic criteria for CMI. These are some of the health concerns this population demographic is expected to be facing, given the median age of 65 years as per the latest census results.

How Nursing Science and Other Influence Impact Population Health Management for Veterans

Nursing science inspires population health management in that interventions depend on the availability of scholarly evidence as proof of their efficacy. In other words, the fact that nursing science is governed and defined by evidence-based practice or EBP impacts population health management for Veterans in a positive way. Only a scientific process of clinical inquiry with a PICOT statement is expected to determine what interventions would in this case be sufficient to manage CMI. Health determinants of social determinants of health also impact Veteran population health management because their income is low or absent (low socioeconomic status).Chronic Multi-Symptom Illness Essay.  Poor living conditions and lack of access to quality healthcare are other social determinants of health that impact the management of their health status. Epidemiologic data for this population also massively impacts the population health management. In the case of CMI for instance, the incidence and prevalence are data areas that must be known before proper planning about management can take place. Lastly but not least, genomic and genetic data will impact the population health management of Veterans because these areas will shed light on whether the Veterans suffering from CMI have some sort of genetic predisposition or if environmental factors are influencing some genes to lead to CMI.

The Potential Effective Intervention or Solution to the Problem of CMI

The PICOT statement for this clinical problem was: Among US Veterans (P), could providing monthly physical assessments and bi-weekly group bereavement meetings during active-duty deployment (I) compared to doing nothing (C) decrease the number of military veterans with CMI (O) within a five-year time span (T)? As the PICOT statement shows, the potential solution to CMI would be a nurse-led process of doing monthly physical assessments and having group bereavement meetings every two weeks at the time of active-duty deployment.

The solution above incorporates health policies and goals because it approaches te management of CMI from a conservative psychotherapeutic approach (Wheeler, 2020). This is in line with healthcare policies touching on these kinds of diagnosis as well as clinical practice guidelines. The goals of treatment include remission and a return to normalcy. These goals support healthcare equity because they do not identify the Veterans by race, ethnicity, or religion.

References

Kojima, G., Kendrick, D., Skelton, D., Morris, R., Gawler, S., & Iliffe, S. (2015). Frailty predicts short-term incidence of future falls among British community-dwelling older people: a prospective cohort study nested within a randomized controlled trial. BMC Geriatrics, 15(1). https://doi.org/10.1186/s12877-015-0152-7

McAndrew, L.M., Helmer, D.A., Phillips, L.A., Chandler, H.K., Ray, K., & Quigley, K.S. (2016). Iraq and Afghanistan veterans report symptoms consistent with chronic multisymptom illness one year after deployment. Journal of Rehabilitation Research and Development, 53(1), 59-70. Chronic Multi-Symptom Illness Essay. https://doi.org/10.1682/JRRD.2014.10.0255

Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice, 4^th ed. Wolters Kluwer.

Reisman, M. (2016). PTSD treatment for Veterans: What’s working, what’s new, and what’s next. Pharmacy & Therapeutics (P&T), 41(10), 623-634. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5047000/

Sadock, B.J., Sadock, V.A., & Ruiz, P. (2015). Synopsis of psychiatry: Behavioral sciences/ clinical psychiatry, 11^th ed. Wolters Kluwer.

United States Census Bureau [USCB] (June 2, 2020). Census bureau releases new report on veterans. https://www.census.gov/newsroom/press-releases/2020/veterans-report.html

Wheeler, K. (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice, 3^rd ed. Springer Publishing Company, LLC. Chronic Multi-Symptom Illness Essay.