Major Depressive Disorder (MDD Essay

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Major Depressive Disorder (MDD Essay

PICOT/The Research Question: The Student will reflect on clinical practice and write a research question. The question will be developed by using the PICOT framework (Population, Intervention, Comparison, Outcome, Time). The Student will identify a question; as follows, what individual or group am I curious about? (population) What key intervention am I curious about? (intervention) What intervention will I be comparing? (comparison) What do I hope to accomplish, or What would happen if I did this? (How much time will the intervention take to achieve the desired effects? Major Depressive Disorder (MDD Essay. The aim of the research question is to add to the body of nursing knowledge and promote best practices. The question will guide the Literature Review and subsequent Research Proposal. The PICOT should have a clinical focus. Please help me come up with a PICOT question that works with this assignment. Please see the example and Rubric I will upload. This has to be Turn it In compliant. This assignment will continue to build upon subsequent assignments. I will need the same author. Please email me when you have chosen a research topic so I can approve it. I will need at least 5-6 peer reviewed references for the topic that you chose

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PICOT QUESTION

Among patients diagnosed with Major Depressive Disorder (MDD) (P) does music therapy (I) compared to pharmacological interventions (C) result in improved psychological, behavioral, affective, and cognitive outcomes(O) within 12weeks?(T)

PICOT TABLE

P	Among patients diagnosed with Major Depressive Disorder (MDD) Depression is a mental illness that commonly presents with; reduced concentration, low self-esteem, feelings of guilt and self-judgment, disturbance in sleep pattern and loss of appetite. Patients with suicidal thoughts have a severe form, require urgent medical treatment. Other symptoms are somatic and cognitive changes that interfere with the individual’s capacity to operate optimally. Significantly the disorder contributes to more than 60% of all the suicide cases globally (Aalbers et al., 2017). Major Depressive Disorder (MDD Essay. Factors associated with the illness include; traumatic experiences, genetic predispositions, chronic illness, substance abuse and personality traits such as low self-esteem. Globally, depression accounts for 3.44 %( 264 million) of mentally ill patients, Bueno-Notivol et al., (2020). Within this population, close to 800,000 youths aged between15-29 commit suicide annually. The condition affects people of all ages; however, it affects women than men. According to Bueno-Notivol et al. (2020), 8% of women have depression than 4% of the male population.
I	Use of Music therapy Music therapy significantly improves the patient’s social well-being when used together with other treatment plans. Music helps by managing some of the symptoms of diseases like anxiety. As such, patients on music therapy can improve their social and psychological well-being when on psycho and pharmacotherapy (Aalbers et al., 2017). Music ignites acetylcholine production, endorphins, oxytocin and dopamine. Endorphins are responsible for life energy, motivation, joy, self-appreciation and optimism. It helps in decreasing pain sensation and promotes feeling a self-satisfaction (Santos et al., 2019). As such, the patient experiences emotional self-regulation, which is significant in reducing anxiety and depression. Additionally, listening to familiar songs improves concentration, social interaction, elevate emotions and recover memories. Incorporation of audio-visual songs that involved singing and dancing improved the symptomatic management of patients with depression (Yang et al., 2019).Major Depressive Disorder (MDD Essay. Among women diagnosed with post-partum depression, music therapy improved maternal attachment by improving their insight.
C	Pharmacological interventions The use of pharmacotherapy in managing depression is successful with other additional therapies such as psychotherapy and music therapy. According to Cuijpers et al. (2020), the use of combined therapy is highly effective in managing depression. Music therapy promotes mood elation and reduces the anxiety that is common among patients diagnosed with depression. Music therapy with pharmacotherapy improves patient well-being by enhancing psychological and cognitive stability. Response to antidepressants varies from one patient to another, as some may have adverse reactions to the drugs. Some patients may experience suicidal thoughts when taking medications. Additionally, pharmacotherapy alone does not encourage a socially withdrawn patient’s social participation (Aalbers et al., 2017). It may not also improve the behavioural change that is desired for people with major depressive disorder. However, it promotes the balances of neurotransmitters in the brain; such balance requires an additional effort that improves patient self-regulation of these neurotransmitters. Aalbers et al. (2017). Music therapy is significant in enhancing process by signalling a process that releases endorphins in the body. Endorphins are responsible for emotional self-regulation in the body and improve the patient’s cognitive and social well-being
O	Improved psychological, behavioral, affective, and cognitive outcomes The management of depression is focused on promoting the behavioral activities, cognitive functions and stabilizing the mood of the patient. However, mood disorders, particularly depression, are usually costly and affect the quality of life adversely. It is also associated with evident morbidity and mortality (Cuijpers et al., 2020). Both pharmacological and non-pharmacological interventions can improve these symptoms. For instance, children and adolescent effectively improve without the use of medications. This is because antidepressants often cause adverse effects and show no improvement compared to behavioral therapies like music and exercises. Major Depressive Disorder (MDD Essay.
T	Within 12weeks Patients on active therapy usually recover within a period of 12-20weeks. Active treatment involves using music therapy as behavioral therapy to improve the well-being of the patient. Other therapies may be included in case patients’ health do not improve. The decision to analyze the therapy in 12 weeks is determined by the standard period when patients start to recover from the disease. Bueno-Notivol et al., (2020) patients diagnosed with depression may have a poor prognosis when the therapy is not substantial to significantly change the patients’ health every time it is applied.

References

Aalbers, S., Fusar‐Poli, L., Freeman, R. E., Spreen, M., Ket, J. C., Vink, A. C., … & Gold, C. (2017). Music therapy for depression. Cochrane Database of Systematic Reviews, (11).

Bueno-Notivol, J., Gracia-García, P., Olaya, B., Lasheras, I., López-Antón, R., & Santabárbara, J. (2020). Prevalence of depression during the COVID-19 outbreak: a meta-analysis of community-based studies. International Journal of Clinical and Health Psychology, 100196.

Cuijpers, P., Noma, H., Karyotaki, E., Vinkers, C. H., Cipriani, A., & Furukawa, T. A. (2020). A network meta‐analysis of the effects of psychotherapies, pharmacotherapies and their combination in the treatment of adult depression. World Psychiatry, 19(1), 92-107.

Ray, K. D., & Götell, E. (2018). The use of music and music therapy in ameliorating depression symptoms and improving well-being in nursing home residents with dementia. Frontiers in medicine, 5, 287.

Yang, W. J., Bai, Y. M., Qin, L., Xu, X. L., Bao, K. F., Xiao, J. L., & Ding, G. W. (2019). The effectiveness of music therapy for postpartum depression: A systematic review and meta-analysis. Complement Ther Clin Pract, 37(101225531), 93-101.

Depression is a mental illness that commonly presents with; reduced concentration, low self-esteem, feelings of guilt and self-judgment, disturbance in sleep pattern and loss of appetite. Patients with suicidal thoughts have a severe form, require urgent medical treatment. Other symptoms are somatic and cognitive changes that interfere with the individual’s capacity to operate optimally.Major Depressive Disorder (MDD Essay. Significantly the disorder contributes to more than 60% of all the suicide cases globally Aalbers et al., (2017). Factors associated with the illness include; traumatic experiences, genetic predispositions, chronic illness, substance abuse and personality traits such as low self-esteem.

This essays addresses the PICOT question, Among patients diagnosed with Major Depressive Disorder (MDD) (P) does music therapy (I) compared to pharmacological interventions (C) result in improved psychological, behavioral, affective, and cognitive outcomes(O) within 12weeks?(T).

Use of Music Therapy in the Management of Depression

Aalbers et al. (2017) describe that music therapy significantly improves the patient’s social well-being when used together with other treatment plans. Music helps by managing some of the symptoms of diseases like anxiety. As such, patients on music therapy can improve their social and psychological well-being when on psycho and pharmacotherapy. Additionally, the therapy has little adverse effects and makes it more tolerable to many patients. However, findings from the paper indicate that the use of music as a single therapy yielded minimal results in the management of the disorder. Patients who listen to pleasurable music develop to chemical pathways in the body. First, it causes increases dopaminergic activity in the brain and decreases the activity of the hypothalamic-pituitary-adrenal axis. In turn, serum cortisol levels drop, and the body releases endocannabinoids such as endorphins. This then results in increased parasympathetic heart functions (Ribeiro et al., 2018). As such, the patient experiences emotional self-regulation, which is significant in reducing anxiety and depression. Additionally, listening to familiar songs improves concentration, social interaction, elevate emotions and recover memories.

According to Ray et al. (2018), music therapy effectively reduces depression symptoms disturbances in patients diagnosed with dementia. However, two-weeks into the therapy, patients started to experience the same symptoms when the therapist include activities like singing and making some movements while the music plays. Incorporation of audio-visual songs that involved singing and dancing improved the symptomatic management of patients with depression. Among women diagnosed with post-partum depression, music therapy improved maternal attachment by improving their insight (Yang et al., 2019). The research paper argues that the improvement in physiological and psychological states enabled their ability to focus on their babies. Additionally, it improved response to pain, promoting adequate sleep, reducing irritability and promoting satisfaction. Cognitively, music encourages transference by arousing joyful memories while reducing negative moods. Major Depressive Disorder (MDD Essay.

According to dos Santos et al., (2019), music ignites acetylcholine production, endorphins, oxytocin and dopamine. Endorphins are responsible for life energy, motivation, joy, self-appreciation and optimism. It helps in decreasing pain sensation and promotes feeling a self-satisfaction. As such, the patient overcomes the feeling of sadness and fatigue. When patients participate in singing, their social ability improves. As a result, the sense of guilt and worthlessness disappears. Therefore, their concentration and self-esteem improve. Santos et al., (2019), music therapy effectively enhances the patient’s symptoms compared to other treatment options.

Conclusion

A meta-analysis of music therapy indicates that it is significant in the symptomatic management of the condition. First, it alleviates anxiety and feeling of worthlessness. It also improves concentration and cognitive abilities, especially when patients participate in singing and dancing or making movements to the song. As such, music becomes the low-budget, most effective non-pharmacological management of depression. However, the use of music therapy with pharmacologic treatment is synergistic and effectively improves the patient’s well-being.

References

Aalbers, S., Fusar‐Poli, L., Freeman, R. E., Spreen, M., Ket, J. C., Vink, A. C., … & Gold, C. (2017). Music therapy for depression. Cochrane Database of Systematic Reviews, (11).

dos Santos, E. A., Marchant Sánchez, E., Niguez Ortiz, M. Á., & Oliver Germes, A. (2019). Effects of music therapy in depression and anxiety disorder. Life Research, 2019, vol. 2, num. 2, p. 64-70.

Ribeiro, M. K., Alcântara-Silva, T. R., Oliveira, J. C., Paula, T. C., Dutra, J. B., Pedrino, G. R., … & Rebelo, A. C. (2018). Music therapy intervention in cardiac autonomic modulation, anxiety, and depression in mothers of preterms: randomized controlled trial. BMC psychology, 6(1), 57.

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In adult patients 65 years and older diagnosed with diabetes mellitus admitted to Inova Fairfax
Hospital medical units, how effective are the use of dietary supplements such as cinnamon
compared to medications such as insulin therapy/oral hypoglycemic in the prevention of diabetic
complications within one year period?
PICOT TABLE
P Adult patients 65 years and older with diabetes admitted to Inova Fairfax
Hospital medical units.
Age is one of the most important risk factors for type 2 diabetes with a high
prevalence in older age groups. Selvin and Parrinello (2013), pointed out that
in the USA adults aged 65 or older, had 20% or more than eight times higher
prevalence of being diagnosed diabetes in 2011 than the prevalence among
adults 18 to 44 years of age (2.4% prevalence).
I Dietary supplements like cinnamon.
It is believed that Dietary supplements like cinnamon help patients to control
blood glucose. As mentioned by Hasanzade et al., (2013), traditional herbs
and spices such as Ròu Guì and Cinnamomum cassia are commonly used for
control of glucose among has the greatest effect. They also added that adding
cinnamon to diet can help to lower the glucose level. Studies revealed that
spices such as cinnamon (Ròu Guì; Cinnamomum cassia), and carnation,
walnut, green tea, and mint have similar effects with insulin action in terms
By SN Ijeoma Amaoji – T2 2020
of reduction of sugar level and the most active of them is cinnamon
(Hasanzade et al., 2013). Major Depressive Disorder (MDD Essay.
C Insulin/Oral hypoglycemic medications.
Insulin alone or in addition to oral glycemic medications are universally used
to treat /manage diabetes due to their ability to bring down blood sugar
levels. Research has shown that insulin offers a unique ability to control
hyperglycemia, when used from the time of diagnosis in some circumstances
and when metabolic control is disturbed by medical illness, procedures, or
therapy, and also being used in the longer term ( Home et al., 2014).
O Prevention of diabetic complications. The ultimate goal of diabetes
management is prevention of long-term complications. Uncontrolled
diabetes can lead to a number of short and long-term health complications,
including hypoglycemia, heart disease, nerve damage and amputation, and
vision problems. According to Vinik & Vinik (2003), chronic complications
can be devastating to patients with diabetes mellitus. The major cause of
morbidity and mortality among these patients, are the complications like
Cardiovascular illness, macrovascular disease, with heart attacks, strokes,
and gangrene; and microvascular disease, with retinopathy, nephropathy, and
neuropathy (P. 571).
By SN Ijeoma Amaoji – T2 2020
T Within one year of being diagnosed.
In most cases, people are diabetic for quite a while without knowing before
receiving the actual diagnosis for it. Complications are said to begin to
develop after having diabetes for a number of years. I chose the time of one
year in consideration to the actual length of time they must have developed
diabetes without knowing. There are no set time frame for complications to
start occurring. Major Depressive Disorder (MDD Essay. It all depends on how uncontrolled the management has
been. The duration of diabetes and the degree of glycemic control achieved
are noted to be risk factors for complications (Nickerson & Dutta, 2012).
References
Selvin, E., & Parrinello, C. M. (2013). Age-related differences in glycemic control in diabetes.
Diabetologia, 56(12), 2549–2551. https://doi.org/10.1007/s00125-013-3078-7
Hasanzade, F., Toliat, M., Emami, S. A., & Emamimoghaadam, Z. (2013). The Effect of
Cinnamon on Glucose of Type II Diabetes Patients. Journal of traditional and complementary
medicine, 3(3), 171–174. https://doi.org/10.4103/2225-4110.114900
Home, P., Riddle, M., Cefalu, W. T., Bailey, C. J., Bretzel, R. G., Del Prato, S., Leroith, D.,
Schernthaner, G., van Gaal, L., & Raz, I. (2014). Insulin therapy in people with type 2 diabetes:
opportunities and challenges? Diabetes care, 37(6), 1499–1508. https://doi.org/10.2337/dc13-
2743
Vinik, A. I., & Vinik, E. (2003). Prevention of the complications of diabetes. The American
journal of managed care, 9(3 Suppl), S63–S84. Retrieved from
https://pubmed.ncbi.nlm.nih.gov/12653455/
Nickerson, H. D., & Dutta, S. (2012). Diabetic complications: current challenges and
opportunities. Journal of cardiovascular translational research, 5(4), 375–379. Major Depressive Disorder (MDD Essay.

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