NURS FPX 4025 Assessment 3 Applying the PICO(T) Process

Applying the PICO(T) Process

Student Name 

Capella University

FPX4025

Prof. Name

Submission Date

Applying the PICO(T) Process

PICOT process (population, intervention, comparison, and outcome and time) includes the systematic actions of generating a clinical research question and an evidence-based practice guide. The PICOT framework is fairly applicable to the framework of diabetic peripheral neuropathy (DPN) of diabetes mellitus, as one of the common and debilitating comorbidities of type 2 diabetes mellitus, as it is applicable to the exploration of the possible interventions that will be taken into consideration, which will positively influence the outcomes of patients.

Nonetheless, the DPN has an enormous impact on the quality of life due to such symptoms as pain, the lack of feeling, and the loss of sensation that increase the risk of developing foot ulcers and amputation (Bodman & Varacallo, 2024). With PICOT, clinicians will be in a position to develop focused clinical questions that will be used to establish the most appropriate remedy in a specific intervention, such as physical exercise or a change of lifestyle, to reduce the neuropathic symptoms or to slow the progression of the condition after a specific period.

Explanation of Diagnosis

The DPN is a non-progressive and horrific complication that is dominant in individuals with diabetes mellitus type II. Besides, there are about 537 million diabetic mellitus patients, and this translates to 10.5 per cent of the entire population of the globe and the same is expected to increase to about 784 million by 2045; therefore, the likelihood of developing complications such as DPN (Tao et al., 2025). DN, being the most prevalent chronic complication of diabetes, makes a significant contribution to the development of diabetic foot problems.

The prevalence rates among diabetic adults have been found to differ greatly and may vary between 7 and 75 per cent, and with more recent studies showing even higher levels. The disabling subtype, painful diabetic peripheral neuropathy (PDPN), is a greater fraction of the global burden of chronic pain and is associated with a higher amputation and mortality rate (Tao et al., 2025). In addition to that, the cost of the PDPN management imposes a huge financial burden on its manifestor because the direct care expenses paid by a person with PDPN in the current year amount to 27,931 dollars, compared to 12,492 dollars in the case of people with non-painful DPN and 6,632 dollars in the case of people who administer diabetes without neuropathy (Tao et al., 2025).

Older adults, ethnic minorities, people with low socioeconomic status, and those residing in rural or underserved communities are at risk of developing DPN and having its complications (Busui et al., 2022). These groups are not usually able to receive proper management of diabetes as they may have restricted access to healthcare services, a lack of health literacy, and may not be able to afford medications and access healthcare services regularly.

As a result, there are differences in care which cause increased prevalence of foot ulcers, infections and amputations in such groups. As an example, the requirement to use several pain-reducing medications and visit healthcare facilities more frequently imposes extra financial strain on families, and people might have a lower working ability or fail to complete their daily duties (Stewart et al., 2022). By improving access to care, prevention education and culturally sensitive care, and with specific screening to identify and prevent DPN and PDPN, it is possible to mitigate the large proportion of these high-risk groups.

PICOT Question

One of the research questions that was created based on the PICOT process to solve the problem of PDPN among patients with type 2 diabetes is as follows: In adults with type 2 diabetes who experience painful diabetic peripheral neuropathy (P), with the implementation of the foot care education and self-management program, based on the nursing (I), and regular care (C) in comparison to the control group (C) after 12 weeks (T), how the severity of pain affects the foot health results (O)?”

• Population: Type 2 diabetes patients suffering painful diabetic peripheral neuropathy (adults).
• Intervention: Foot care education and self-management program led by the nurse focused on the daily inspection, hygiene, protective behaviours, and pain management.
• Comparison: Normal care in the absence of educational or follow-up interventions administered by a nurse.
• Outcome: The benefit is that it affects the levels of neuropathic pain and results in a better outcome of foot health, e.g. reduced ulcers or skin breakdown.
• Time: Assessed in 12 weeks of interventions.

Alignment with the PICOT Criteria

This research question is an excellent example of an effective accomplishment of each constituent of the PICOT model. The Population (P) is distinctly stated as any adult with type 2 diabetes and painful diabetic peripheral neuropathy, which is a high-risk factor in developing foot complications and reduced quality of life. The Intervention (I) is an intervention that includes a foot care education and self-management program that is led by nurses, pointing to the importance of nurses in the education of chronic diseases, their prevention, and monitoring (Dailah, 2024). Comparisons (C) is the standard care that does not usually include personalised and structured guidance, as provided in the nursing-led programs.

The Outcome (O) is aimed at decreasing the level of pain and enhancing the outcomes of the foot health that are clinically measurable and significant to the well-being of a patient (Riskowski et al., 2011). Time (T) is established in the framework of 12 weeks, and it would be enough to monitor and evaluate the effect of the intervention. By addressing all of these requirements, the question directs an informed, practical, and evidence-based investigation towards better nursing practice and patient outcomes in diabetic care.

Research of Literature for Diabetic Peripheral Neuropathy

To conduct an intensive literature search of the nurse-led interventions for DPN and foot care in type 2 diabetes, various reputable databases have been searched, including CINAHL, MEDLINE, Scopus, and Google Scholar. The selection of these databases is explained by the fact that they are focused on studying health sciences and nursing research (Oermann et al., 2021).

The first search terms were the combination of the following words: nurse-led interventions, diabetic foot care, diabetes self-management education (DSME), type 2 diabetes and the African Sub-Saharan. These Boolean operators between, including, o,r and not were employed to refine/expand the results, e.g., nurse-led and diabetic foot prevention DSME, or diabetes education, and Sub-Saharan Africa. Filtering was performed to make the search more relevant and current, i.e., only peer-reviewed articles, English language, and the time of publication (2020-2025) were added.

The search process was refined stage by stage until the most qualified and acceptable studies were generated. The findings at the first phase included a lot of articles, most of which were irrelevant to the issue of the nurse-led program or Sub-Saharan Africa in particular. These findings have been reduced simply by refining keywords and using the inclusion criteria, such as limiting the research to studies on adult patients with type 2 diabetes and interventions administered by nurses or the inclusion of DSME.

Titles and abstracts screening was followed, and thereafter, full-text screening was done on the eligible studies. The factors that were applied in the evaluation of the credibility of the sources were journal reputation, concept of peer-review, and the size of the sample, research design, and fit to the research question. This authorised search strategy ensured that the end product of the articles contained very strong and scientifically based information regarding the role of nurses in the prevention of diabetic foot and neuropathy.

Explanation of Evidence from the Sources

Sajith et al.’s (2024) study was a scoping review of studies that were aimed at exploring the scope, nature and performance of nurse-led foot care and educational measures among patients with type 2 diabetes in Sub-Saharan Africa (SSA). According to their findings, it is required to state that the DSME programs run by nurses are available, but there are limited programs that are focused on preventing diabetic foot.

Through the review, it has been noted that effective DSME interventions are usually culturally competent, well-designed and involve group interaction activities which have a positive influence on Glycemic control and self-management practices. The authors pointed out the necessity to develop sustainable, co-designed, and resource-efficient nurse-led interventions that could be used to mitigate the given care gaps, particularly in underserved communities in SSA.

Ture et al. (2023) assessed the effects of a nurse-based DSME program on 281 patients having type 2 diabetes in a different study. which validated the notion that nurses played a role in enhancing the management of diabetes. On the same note, Tamiru et al (2023) employed a quasi-experimental study that comprised 278 individuals to evaluate the impact of DSME on knowledge and behaviour. The intervention led to a noticeable increase in the number of patients who possess high rates of diabetes knowledge and sufficient self-care practices, which means that nurse-led education can be used in patient empowerment to enhance their ability to control their condition.

Credibility and Relevance to Diabetic Peripheral Neuropathy

Of the three sources, the work by Sajith et al. (2024) is the most credible one since it is a scoping review conducted in Frontiers in Public Health, a high-impact peer-reviewed journal, and adheres to the PRISMA guidelines, which guarantee methodological rigour. This is a synthesis of evidence based on various studies within the SSA, and presents a more general and well-grounded view of the issue of nurse-led interventions.

Ture et al.’s (2023) study is also very credible since it is published in the Journal of Diabetology, has a large sample (n=281) using strong quantitative methods that are reliable in giving clinical outcomes. Although credible, Tamiru et al. (2023) is a moderately ranked source since it is published in a niche regional journal and has a quasi-experimental design, though it is a relevant source since it addresses the topic of DSME in low-resource clinical environments.

Explanation of the PICOT Question

In order to answer the PICOT question: In adults with type 2 diabetes who develop painful diabetic peripheral neuropathy, does a nurse-led foot care education program, compared to usual care, decrease the severity of pain and improve foot health outcomes in 12 weeks? The present evidence points to the effectiveness of nurse-led initiatives on diabetes self-management education. In a study conducted by Türe et al. (2023) and Tamiru et al. (2023), significant improvements were observed in the clinical outcomes (blood glucose, HbA1c, BMI, and self-care practice of patients) after the implementation of structured nursing interventions.

Although Sajith et al. (2024) indicated a gap in nurse-led initiatives addressing the aspect of foot care in Sub-Saharan Africa, their study provided a reminder of the critical role of culturally appropriate and jointly created educational programs as the building blocks in the prevention of diabetic complications, including foot complications.

Underlying Assumptions

The analysis has been made on the basis of a number of assumptions. First, it presupposes that a better glycemic level and better self-care practices have a direct impact on reducing the extent of the PDPN symptoms and foot-related complications. It also presupposes that structured DSME content also incorporates or can be expanded to incorporate foot care education, even though it is not always directly mentioned in any study. Moreover, the analysis assumes that the nurse-led programs can be expanded and spread uniformly in various environments, even in low-resource regions. Based on these assumptions, it is concluded that a nursing-based educational intervention can be effective and functional in enhancing patient outcomes with PDPN.

Conclusion

In particular, interventions that are led by nurses, particularly the DSME, play a pivotal role in the improvement of the outcomes of patients with type 2 diabetes undergoing painful PDPN. The evidence reviewed by the authoritative sources demonstrates that these kinds of interventions are critical factors of the outcomes of self-care behaviours, glycemic regulation, and clinical outcomes, although few foot-focused nurse-led interventions in Sub-Saharan Africa exist. The prevention of diabetic foot can bridge the gaps after which the structured education programs should be created, but these must be culturally appropriate and co-produced to meet the needs of the vulnerable population.

For the 2nd assessment of this class visit: Nurs FPX 4025 Assessment 2